What will the surgery involve?
i. Anaesthetic – Usually a light general anaesthetic together with a local anaesthetic around the ankle
ii. Scar – This will be over the top or on the inside of the big toe joint
iii. The surgery – The joint at the base of the big toe will be stiffened and held together with 2 screws or a plate and screws.
iv. Stitches – Dissolving sutures will usually be used. If removable sutures are required these will be removed at your appointment about two weeks after surgery.
v. Dressings – Special dressings will be placed on the foot that should be left in place until you are reviewed in clinic.
You will have a “post operative shoe” rather than a plaster. This should be kept on at all times (including night), unless instructed otherwise.
What happens after the surgery?
i. Return home – Either the same day or the following morning.
ii. Pain relief – The local anaesthetic placed around the ankle at the time of surgery will wear off several hours after surgery. It is important to take the pain relieving tablets regularly before the local anaesthetic wears off. You can gradually reduce the frequency with which you take these after twenty four hours.
iii. Walking – You will be able to walk once you have recovered from the anaesthetic, but only when wearing the post operative shoe. When walking you should keep your weight on your heel.
It is important to keep your foot elevated when you are resting, as much as you can for the first two weeks after surgery (if possible above the level of your heart). If you do not keep it elevated then the foot will swell, throb and be uncomfortable.
iv. Shoes – You will be able to wear ’more normal’ shoes when the post operative shoe is removed, usually at 6-8 weeks depending on the X-Ray. You may have some difficulty fitting into your normal shoes at this stage as the foot may be swollen, this can last up to 3 months.
v. Driving – This is not permitted until you can walk confidently in normal shoes, however if the surgery is on your left foot and you have an automatic car you may be able to drive after you are seen in the clinic two weeks after surgery.
In all cases you should check with your insurance company first.
vi. Follow up – You will be seen in the outpatient clinic at:
2 weeks after surgery for wound review
6 weeks after surgery when an X-Ray will be obtained, if this is satisfactory then you will be able to start walking without the post operative shoe.
3 – 4 months after surgery, further follow up will depend on your progress.
vii. Return to work
Office job – 2 weeks
Mobile job requiring driving – 6-7 weeks
Manual labour – 8-10 weeks
What are the risks of the operation?
There are a small number of risks of surgery including infection, nerve damage, blood clots, ongoing pain and the need for further surgery (please see General Risks of Foot and Ankle Surgery for further information)