Forefoot reconstructive surgery

Forefoot problems are often caused by rheumatoid arthritis. Symptoms can be painful causing deformities such as:

• Bunions
• Hallux ridgitus (stiff big toe joint)
• Metatarsalgia pain (pain in the front part or ball of your foot)
• Claw toe
• Hammer toe

Initially conservative treatments such as modifying your shoes or using shoe inserts (orthotics) may relieve your symptoms. If conservative treatment does not work for you, your consultant may recommend forefoot reconstructive surgery.

What happens during forefoot reconstructive surgery?

Forefoot reconstructive surgery is usually performed under general anaesthetic. The extent of your surgery will depend on your own situation.

Usually your big toe will be fused making it stronger and straighter. Fusing also allows your big toe to take on more weight as you walk.

Your small toes may also be straightened. Your surgeon will make a small incision (cut) over the top of your toe. They will remove a small piece of bone from the base of your toe so that it will drop into a flat position. They will also repair any ligaments or tendons. Sometimes a pin is used to ensure the toe stays in position. All wounds will be closed with stitches.

Your foot will be wrapped in a firm dressing. We will give you medication for pain relief.

Going home after forefoot reconstruction surgery

Your length of stay in hospital will depend on how well you are able to move around after your procedure. You may need to stay 1 or more nights. You will not be able to drive. Please arrange for someone to take you home on the day of discharge.

Your dressing will be in place for the first 2 weeks. Keep it clean and dry. Continue to take any pain relief medication as needed. Elevate your foot as much as possible. If your big toe has been fused you will need to walk placing most of your weight on your heel. Since your toe will be fixed into one position you may need to wear low heeled shoes.

After 10-14 days you will need to return to have your stitches removed. Your consultant will may recommend using a brace or a cast may be applied.

Please discuss any return to work or sports activities with your consultant.

Most people make a full recovery from forefoot reconstructive surgery. As with any surgery there could be complications:

• Pain
• Bleeding
• Infection
• Blood clots (deep vein thrombosis)

Specific complications of forefoot reconstructive surgery:

• Plaster problems
• Nerve damages
• Swelling
• Toe fusion fails