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What are the indications for this surgery?

This type of surgery is performed to correct a flexible lesser toe deformity. The operation involves releasing tight tendons that drive the deformity. The benefit of this operation is to reduce pain and progression.

First MTPJ fusion (big toe fusion): Text

What does surgery involve?

This procedure is usually performed as a day case. It is normally performed under local anaesthetic. A small incision is made over the tendon which is then cut. 

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After surgery your toe will be taped and the foot bandaged in a bulky dressing. Your foot will be protected in an orthopaedic shoe for 2 weeks and you will be allowed to walk on the operated foot. You will have a your stitch and dressing removed at 2 weeks.

First MTPJ fusion (big toe fusion): Text

Aftercare and FAQs

It is important to keep the foot elevated as much as possible especially for the first 3 days.

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You will usually be able to go home when you feel ready. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours. 

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Wound care – The bulky dressing should be kept on until your clinic appointment.

 

Walking - Try to keep your foot elevated as much as possible to prevent swelling. You will be able to walk on the day of your surgery unless advised otherwise.  You may mobilise freely around the house but long walks or standing for long periods should be avoided. You may need to use a stick or crutches for a few days.

 

Work - If you have a sedentary job you should be able to return to work within 48hrs. If your job is physical, you may need to stay off work for at least 2 weeks.

 

Driving - You will not be able to drive for 2 weeks following surgery. However, if you drive an Automatic and it was your LEFT foot that was operated on; then you may start short drives the day following surgery. It is advisable to check the terms of your car insurance to ensure your cover is valid, as some policies state that you must not drive for a specific time period after an operation.

 

Flying after surgery - It is generally recommended to wait at least two weeks to fly. It may be possible to fly on short-haul or domestic flights at an earlier time, but you should always check with your GP or surgeon. Always consult your doctor, your health insurance provider and the airline you are flying with before making your flight reservation.

 

First MTPJ fusion (big toe fusion): Text

What are the surgical risks?

 

  • Infection - there is a small risk of infection with all surgery. If this occurs it will be treated with relevant antibiotics. 

  • Pain - for most people the pain passes after 24-48 hours and is tolerable with regular painkillers.

  • Swelling - this is quite common. In some people the swelling reduces within a matter of weeks and in others could take a few months. 

  • Deep Vein Thrombosis - also known as Venous Thromboembolism (VTE), this is a rare complication of foot surgery.

  • Nerve damage – this may leave you with numbness or a sensitive scar. 

  • Recurrence of deformity.

 

It is beyond the scope of this document to list rarer risks (less than one in a thousand) but I will be very happy to discuss any worries about specific concerns and also about any family history or your past health problems. If there is anything you do not understand or if you have any questions or concerns, please feel free to discuss them with me.

First MTPJ fusion (big toe fusion): Text
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