Minimally Invasive Big Toe Surgery

Many people develop a stiff big toe with limited movement. This condition is known as hallux rigidus. Arthritis is the most common cause of this condition. This condition causes the big toe joint to become increasingly painful, stiff and swollen. Patients often notice a painful lump on the top of the big toe joint (sometimes called a dorsal bunion). This can cause pain when wearing shoes.

This type of surgery is known as a cheilectomy. Traditionally it involves an incision of 4cm centred over the big toe joint. The ridge of arthritic bone is removed from the upper surface of the joint with either a saw or chisel. Removal of the painful lump on the top of the big toe joint is aimed at eliminating pain and increase the big toe joint movement.

Dr Peter Lam starts by making a 3mm incision on the side of the big toe. The prominent bony ridge is removed by a fine high speed burr under x-ray guidance. The joint is then meticulously flushed out to remove any bone debris. The incision is taped with a steristrip and does not require stitches.

This procedure is a day surgery operation. Patients are admitted to hospital on the day of surgery and meet the anaesthetist prior to surgery. The anaesthetist will discuss the anaesthetic involved. Local anaesthetic is injected around the surgical site following the operation.

Following the operation a bulky dressing is applied around the foot. This should remain in place for approximately 1-2 weeks. It is important to keep the dressing dry to reduce the risk of post-surgical infection.

The patient may walk straight after the operation. Crutches may be required for the first few days after surgery depending on the patient’s comfort.

Patients are able to wear their own shoes after the dressing is removed.