The Foot and Ankle Clinic

Hallux Rigidus

What is hallux rigidus? | What symptoms might I get with hallux rigidus? | What causes hallux rigidus? | I have a bunion but my toe is also very stiff and painful | What treatments are available? | What are the most common operations for hallux rigidus? | What is a debridement and how does it work? | After the operation | What is a Fusion? | The operation | After the operation | I still don't like the sound of a fusion, what about a replacement?

 

On the Day

Pain relief

After the surgery when the anaesthetic has worn off, the foot should be largely free of pain due to the use of nerve blocks. The patient will be given a course of painkillers and anti-inflammatory medication. These will be working for when the nerve blocks wear off in 12 hours or so.

The foot

This will be in a post-operative bandage.

post-operative bandage

Generally we avoid using plaster casts. If the bandage feels too tight it can be gently loosened.

The foot should be kept elevated as much as possible when resting for the first 48 hours. Try to avoid letting it hang down when sitting and put up on a pillow or two at night.

Mobility

A physiotherapist will instruct you on the use of crutches and your post-operative shoe( dgx1). Generally you may put as much weight through the foot as you wish, providing it is comfortable and as long as you remain in the shoe for walking.

Length of stay

This is generally performed as daycase surgery

At two weeks

The patient will require an outpatient review and wound check. The dressings will be removed and the patient may now get the foot wet. The patient will be instructed on excercises to minimise post-operative stiffness. You may do any activities you are able to.

How likely is it to work?

The chance of success is 90-95%.

It can sometimes take months for a joint to settle after such a procedure .

What is a big toe fusion, how does it work, and what can I do afterwards?.

After a successful big toe fusion the two bones which formed the joint ( metatarsal and proximal phalanx )are permanently "bonded" together and no longer move.

fusion
fusion

The joint surfaces which generated pain are removed at the time of the fusion. The "bonding" process is a normal healing process which is induced to occur by the operation.

A bit like with a fusion of the ankle the joints further on from the fused joint can take over some of the function. The joint itself is fixed in a position of slight extension . This allows the front part of the foot to function normally as a "rocker", whilst the IP joint which remains mobile allows the toe to make contact with the ground.

post operative fusion 1
post operative fusion 2
post operative fusion 3
post operative fusion 4
post operative fusion 5

After the bone has fully united (6-12 weeks) there are no restrictions on activity.

You will probably find that you are limited in the height of heel which you are able to wear, as a result of the fixed position of the big toe. This is not always the case however (see above and gait videos below).

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