HALLUX MTP FUSION
Fusion of the hallux MP joint.
What is it?
This operation is designed to glue (fuse) the big toe joint together. It is also called an arthrodesis of the big toe or metatarsophalangeal joint (MTP). This is a very commonly performed operation for arthritis and deformity of the big toe (severe bunions) joint and sometimes in conjunction with other toe deformity corrections.
Arthritis of the MTP joint implies that there is no cartilage left and bone on bone grinding is occurring causing swelling, pain and deformity which is not salvageable and the body is in the process of fusing this joint which may take months to years.
Surgical fusion speeds up this process and the toe is positioned according to the need to roll off the big toe, exercise or the desire to wear different types of shoes including high heel shoes.
Once fused, the big toe does not move except at the end joint.
Once fusion is successful, you will be able to wear most shoes, including a high heel if desired of about 3 cm.
There are no limits to exercise activities after the fusion, including all sports and running.
General Recovery Facts
- You are able to walk on the outside of the foot the day after surgery.
- You must wear your surgical shoe at all times until the joint is fused.
- You may not walk on the bare foot at all even in the house without this shoe.
- You may drive as soon as comfortable, usually at 7 days if the right foot and 10 days if the left foot.
- The surgical shoe is worn for 6-8 weeks
- Limited exercise that does not involve any bending of the big toe joint is allowed at about four weeks after surgery.
- You will be prescribed oral vitamin D 50,000 international units by mouth weekly until fusion is complete on x-ray.
Before & After Pics
Specific post-operative recovery
- Foot wrapped in bulky bandage and surgical shoe.
- Do not remove surgical shoe – even at night.
- Ice, elevate, take pain medication.
- Expect numbness in foot 12-24 hours then pain.
- Blood drainage through bandage is expected, do not panic unless continuous bleeding occurs.
- Do not change bandage under any circumstances, contact my rooms before any such thoughts cross your mind.
- Continue walking in surgical shoe with crutches at all times.
- May drive with caution in surgical shoe (if driving an automatic car, may be able to drive sooner) after the first week and if you are able to apply pressure to the break pedal in an emergency situation.
- Wound check with dressing Sister.
- Scar therapy commenced with micropore and Bactroban antibiotic ointment for a period of 4-6 weeks.
- Shower when incision dry.
- Most of the time absorbable sutures are used and do not need to be removed as these will dissolve.
- Continue with post-operative shoe for a further 4 weeks.
- Continuation of vitamin D supplementation as prescribed.
- Weight-bearing control x-ray.
- Remove surgical shoe.
- Do not roll off on the big toe for one more month.
- A stiff soled shoe is important for one to two months.
- A regular shoe may then be worn as comfortable.
- No high heel is worn for two more months.
- Sometimes it may be necessary for a computer gait analysis of the foot to be performed, and possibility of orthotics discussed at this point.
- Control weight-bearing x-ray taken.
- Almost all activities can be resumed at this stage.
- Residual swelling and possible scar numbness expected at this point which will resolve with time (6-9 months post operatively worst-case scenario).
- Six-month followup in consultation with weight-bearing control x-ray.
- Pictures taken for comparison to preoperative state.
- Functional outcome score taken.
- 1-year followup in consultation rooms with weight-bearing control x-ray.
- Pictures and video taken for comparison to preoperative state.
- Functional outcome score taken.
- Patient is usually discharged at this point.