CHEILECTOMY
PLEASE KEEP YOUR FOOT ELEVATED ABOVE YOUR HEART AS MUCH AS POSSIBLE FOR THE FIRST FEW WEEKS AFTER YOUR SURGERY
Cheilectomy of the Big Toe
A Cheilectomy is an operation to remove bony lumps (spurs) on the top of the main joint of the big toe – the first metatarsophalangeal joint, which is almost always caused by arthritis.
Why is it Done?
This operation may be done if you have a bony lump, which is pressing painfully on your shoes, or to treat early arthritis of the big toe.
What does it Involve?
You will have either a general or local anaesthetic. A small incision is then made over the side of the big toe and the lump is removed. The toe joint is also examined and cleaned out. The incision is then stitched up.
Can it be Done as a Day Case Operation?
This procedure is usually done as a day case operation if you are in good health. If you have other problems, you may be required to stay in overnight post operatively.
A follow up appointment with Mr Williams for one week’s time will be made before leaving the hospital.
What Happens Afterwards?
You will not have any plaster on your foot after the surgery, as it is important to start moving your toe as soon as possible to avoid stiffness problems. The bandages will be removed one week following your surgery and you can commence gentle movement then. This is not always the most comfortable, so you can start gently and work harder at it.
You are allowed to walk on the foot straight away and this is preferable as it helps to avoid stiffness. When you are not walking, try to keep your foot up – elevated – as much as possible to avoid swelling.
One Week After Surgery
You will need to return to the clinic to check your wound and refer you for physiotherapy.
Why do I need to Attend Physiotherapy?
It is important that you regain as much function as possible from your foot after toe surgery. As the joint will be stiff and swollen in the early stages post operatively, it will limit how well you are able to walk.
Physiotherapy will include mobilising your toe joint and foot to help you regain normal movement. You will be given exercises to do at home until you are moving properly and your foot is comfortable. Your physiotherapist will advise you when to return to normal activities.
Physiotherapy will maximise the effect of your operation. If the joint was left to heal on its own, it may remain stiff and affect your walking. This can lead to further ankle, knee and back problems. On average, 8 sessions over a course of four weeks is necessary.
5-6 Weeks After Surgery
This is often your final post op check up. Once again, the joint will be examined and you should use this opportunity to ask any extra questions that may have arisen since the surgery.
If the operation was done for the bony lump alone, it will almost never grow back.
If the operation was done for arthritis, you will probably notice an improvement in the arthritic pain within a month. There is usually an increase in the movement in the joint of about 20 degrees compared to pre operatively.
Returning to Normal Activities
Returning to Work
Mr Williams or your physiotherapist will advise you about returning to work. If you have a sedentary job that you could do with your foot up most of the time, and you can get to work, you could probably go back to work one week after surgery. On the other hand, if you have a heavy manual job, you may be off for up to two months. If you need to drive to work, this will affect when you can go back.
Driving
You can drive as soon as your foot is comfortable enough and you can wear a suitable shoe. Usually this is 2-4 weeks after surgery. You must be comfortable and not too stiff before trying to drive. Start by sitting in the car and trying the pedals then drive round the block. Drive short distances before long ones. Remember, if you cannot safely make an emergency stop, your insurance will not cover you in the event of an accident. Ask your surgeon when it is safe for you to drive again.
Playing Sport
As the swelling in your foot goes down and it becomes less stiff, you can start gently exercising your foot and walking further each day. When you are comfortable doing this, you can start gentle running and stretching. Contact, twisting and impact sports can follow as comfort dictates. Everyone is different in how quickly they can exercise again – be guided by your own body’s reactions and the advice of your surgeon. Most people can get back to most of their previous activities within 4 months of a Cheilectomy.
What can go Wrong?
Some discharge from the wound is quite common after a Cheilectomy, as the exercises for your big toe tend to stretch the healing wound. Usually this is only slight, if you are worried, contact the clinic.
If you develop a fever associated with an increase in pain and a discharge from the wound please call Mr Williams’ secretary. If you have any questions please call Mr Williams’ secretary.
Thank you.
