BIG TOE JOINT FUSION

You have developed arthritis of the big toe joint which is often associated with bony bumps on the side or top of the foot. Sometimes the big toe may have turned towards your second toe. This bump(s) may have become red and sore and is known as a ‘Bunion’. Sometimes the second toe also changes position and lies above or below the big toe.

Arthritis of the big toe joint is fairly common in people over 50. Bunions are usually familial and more common in females. Wearing shoes that are too tight or being flat-footed may also contribute to the formation of a bunion/ arthritic joint.

Pads, splints, foot orthoses and special shoes can be used to provide comfort but will not straighten the toe or cure the arthritis. Pain medication may also be used. If the bunion or arthritic big toe joint is still uncomfortable despite these measures then an operation will usually be recommended.

The operation, called a joint fusion, will involve removing the joint surfaces from each side of the big toe joint and then holding the bones together while they knit to become one bone. The bones are held together by screws or a plate, which are buried and not removed unless they cause problems. Following surgery the toe is left slightly shorter than before but should be pain free and straight. The surgery can be performed under general or local anaesthetic. The foot will be heavily bandaged after the operation.

Generally 90 – 95% of people are happy with their surgery.

For the first 48 hours you will rest in bed with your legs elevated and should take the painkillers prescribed for you. You will be asked to do some foot exercises during this time. The bandages will be left on for 2-6 weeks. You will be given an Outpatients appointment to return to have the bandages removed. You will be able to return to work from 2-8 weeks after the operation, depending on whether you need to stand or walk around a lot for your job. You will not be able to drive until you come out of the post-operative shoe.