A Cheilectomy surgery is a specialized procedure where a surgeon removes a bony, hard lump from the largest big toe joint. These lumps are often caused by hallux rigidus (big toe arthritis) and osteoarthritis, resulting in pain, stiffness, and limiting mobility. This surgery aims to relieve this pain.
What Is Cheilectomy Surgery?
If you suffer from pain or stiffness in the big toe joint (also known as hallux rigidus arthritis) or a bony lump that forms at the tip of the toe joint and causes movement or pain, you may need a cheilectomy.
Your doctor will try non-surgical procedures before recommending surgery.
Hallux Rigidus is a degenerative disease that leads to arthritis of the first metatarsal joint. Cheilectomy is a surgical procedure that can be used to treat this disease.
It removes dorsal, dorsomedial, and dorsolateral osteophytes to alleviate the impingement of the first metatarsal joint that causes pain to the patient.
Cheilectomy has proven to be an excellent method of removing bony spurs to alleviate symptoms with minimal surgical complications and a quick recovery.
Cheilectomy is usually performed as a daily procedure under general anesthetic, although a local anesthetic of the feet can be administered to minimize the pain.
You will receive specific instructions from your surgeon or primary care provider on how to prepare for your Cheilectomy.
A pre-registration examination is required to ensure that the procedure is safe for you. The test should be performed between 10 and 14 days before the surgery.
These include blood tests, chest X-rays, and an electrocardiogram (ECG). These tests can help identify underlying health problems that could make the procedure riskier for you. If you smoke or use nicotine, you may be asked to stop before the procedure.
It is recommended to stop smoking eight weeks before the operation, as smoking can impair healing and cause health problems, such as an increased risk of pulmonary embolism (clots in the lungs and deep veins) and thrombosis (blood clots in the calf).
There is evidence that nicotine impairs wound and bone healing after surgery. Smoking increases the risk of blood clots and infections, so it is recommended to give up smoking at least four weeks before surgery.
Tell your provider about all other over-the-counter or prescription medications, including vitamins and herbal remedies.
You should ask your surgeon if you need to use certain medications, including NSAIDs and aspirin, in the 7 days before the surgery. You may also be asked to fast before and after your surgery.
Make a plan for someone to drive you to and from the procedure. Cheilectomy is performed during anesthesia, which means you sleep during the operation. You should drink clear liquids for at least three hours before surgery.
Using general anesthesia means you won’t feel anything during the operation. You will need a local anesthetic to numb the toe area.
The surgeon will make a single keyhole incision at the tip of your big toe. The surgeon removes excess bone accumulations around the bone joint and other deposits, such as loose bone fragments or damaged cartilage.
After removing the bone, the surgeon closes the incision with dissolving sutures. The surgeon will then bandage your toe and foot.
Recovery From Cheilectomy
Participating in a checkup is the best way to maximize the benefits of your surgery. Here you will have your blood tested to determine your vitamin D levels and have swabs done to check for infections and other problems that you may have.
Attending a checkup also allows you to discuss your medical history to highlight possible anesthesia problems.
You will receive crutches or special protective shoes to help you walk. This allows you to stand and walk normally after the operation. You are monitored for two to three hours after surgery in the recovery area and then discharged to your home.
Make sure you don’t put too much weight on the front of your foot. You will be shown how to walk with a flat foot without putting more weight on the heel.
In the first few days after surgery, you may have throbbing pain. You may be prescribed painkillers to make you feel better.
Swelling is common, but you can manage it by keeping your foot elevated (lay flat with your leg raised above your heart) in the first week after surgery. Ice packs or bags of frozen vegetables can help with pain and swelling.
Once the incision has healed, you can soak your foot in cold water to reduce the swelling. Your surgeon or nurse will give you bathing instructions to ensure that you do not interfere with the healing process of the stitches. It is important to keep these dry and clean.
After the operation, the physiotherapist will discuss your rehabilitation program with you. They show you how to walk with padded or stiff shoes.
In most cases, you will be sent home with gentle stretches and exercises while you recover. Make sure you understand these and how they can make a big difference in recovery.
Depending on your work, you can return to work within two weeks of the operation, but if your work requires heavy manual work, you may need up to six weeks.
In the first two weeks after the operation, you will have sturdy hospital shoe support, but it is more likely that you will be back in your own shoes after six weeks. During your stay in the hospital, you should try to rest as much as possible and minimize movement.