Orthopaedic Surgeon
Specialist in Foot & Ankle Surgery and Children’s Orthopaedics
 
The Barouk post-operative shoe

MTP fusion - operative information

You have been recommended to have an operation called an MTP fusion (arthrodesis).  This removes the painful arthritic big toe joint and stiffens it permanently.

  • The aim of surgery is to abolish your pain and improve your function.
  • Surgery is performed under a general anaesthetic, through an incision usually on the top of the foot.  The joint is removed and the bones are stabilised using two large metal staples. These usually remain in your foot permanently but if they cause problems such as pressure under the skin, they can be removed at a later date.
  • You will be in hospital for one night and will mobilise the morning after surgery with the help of the physiotherapists. You will wear a special heel-bearing shoe, which relieves weight from the forefoot.
  • In the first week you will be required to elevate your foot as much as possible at home to minimise swelling. You will be seen at one week from surgery, where the wounds will be checked and the stitch ends trimmed.
  • You will continue to mobilise increasingly in the shoe such that you will be able to get out and about although you will not be able to drive at this stage.
  • You will be seen at six weeks from surgery where an X-ray will be taken to confirm healing of the fusion site. Assuming all is well, you will be allowed to mobilise using more normal footwear and will be able to commence driving.
  • Swelling may persist in the foot for up to three months, although usually only minimally.
    Your function is likely to return to near normal by approximately three months.  The end point of recovery is usually between six and nine months, but from three months you are walking independently and beginning to exercise.
  • As with any other surgery complications may occur. There is a risk of infection whenever the skin is cut, but this is less than 1%.  The fusion may not heal within six weeks and further time may be required.  There is approximately a 5% chance that the fusion does not heal first time and further surgery may be required, perhaps using a different fixation technique or bone graft.  Occasionally there may be nerve injury during the operation, such that you have numbness or pins and needles along the toe. This is usually temporary, although on occasion may persist permanently. This usually does not cause problems however.

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