What will the surgery involve?
i. Anaesthetic – usually a general anaesthetic is required; local anaesthetic will also be injected around your ankle (ankle block) to reduce the pain after surgery. You will have a chance to discuss your anaesthetic with the anaesthetist before the operation.
ii. Incisions – A small incision on the top of the foot over the neuroma
iii. The surgery – The neuroma is identified as it passes between the bones at the base of the toes and is then surgically removed.
iv. Stitches – Dissolving sutures will be used to close the skin. The ends of these sutures will be trimmed at your appointment about two weeks after surgery.
v. Dressings – A dressing will be placed over the wound that should be kept in place until you are seen in the outpatients 2 weeks after surgery.
What happens after the surgery?
i. Return home – This will usually be on the same day as the surgery.
ii. Pain relief – The local anaesthetic “ankle block” should provide some pain relief, but you will be supplied with pain relieving tablets by the hospital (usually co-codamol and tramadol) these should be taken regularly initially.
You will find it more comfortable to keep your foot up on a chair, if possible above the level of your heart, as much as you can for the first two weeks after surgery. This will help reduce the swelling and therefore also help wound healing. There will be a degree of swelling of the foot that may persist for 3 months.
iii. Walking – You will probably require crutches for a few days, but these can be discarded when you feel you no longer require them. You will probably find it more comfortable to put the majority of your weight on your heel, but you can place all of your weight on your foot.
iv. Follow up – You will be seen in the outpatients 2 weeks after surgery, when the dressings will be removed from your foot and the suture ends trimmed.
v. Driving – You will not be able to drive until you can walk without crutches confidently. You should usually be able to start driving two weeks after surgery, or earlier if the surgery is on your left leg and you have an automatic car. You should check with your insurance company first.
vi. Return to work – Approximately:
Office job – 2 weeks
Mobile job requiring driving – 3-4 weeks
Manual labour – 4-6 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)