Do you also feel pain in the big toe joint when you walk, especially when wearing shoes? Do you feel a tightness or a small lump in your toe, making it difficult to bend? This is a problem that many people have and that interferes with their daily activities. Today, we will talk about what causes this and the simple procedure called Cheilectomy.
What exactly is this stiffness in the big toe (Hallux Rigidus)?
Simply put, Hallux Rigidus is a condition of arthritis (`(Osteoarthritis)`) that occurs in the main joint of your big toe (medically we call this the MTP joint or Metatarsophalangeal joint ). Just like the knee joint wears out.
When this happens, new bone spurs, like spikes, start to form around the joint. We call these bone spurs (`(Osteophytes)`). These bone spurs cause a small bump to appear on top of the joint. This bump can cause severe pain when it hits the shoe. Also, these bone spurs limit the movement of the joint, meaning that the big toe cannot be bent up and down properly. This stiffness is what we call "Rigidus".
Why is Cheilectomy performed?
Your doctor will usually only recommend Cheilectomy if your Hallux Rigidus condition is mild or moderate and has not been relieved by non-surgical treatments.
Before resorting to surgery, doctors always try to provide relief to the patient through other treatment methods.
The following are commonly used non-surgical treatments:
| Treatment method | Description |
|---|---|
| Corticosteroid injections | This injection, administered directly into the joint, can temporarily control pain and swelling. |
| Activity restriction | Stay away from things that increase pain, such as running and jumping, for a while. |
| Painkillers (NSAIDs) | Medications such as ibuprofen can help reduce pain and swelling. These should be used under the advice of a doctor. |
| Special footwear and orthotics | Wearing thick-soled, rigid shoes that restrict joint movement. Sometimes special supports (orthotics) are used inside the shoe. |
If none of these things help you, the next step your doctor will discuss with you is cheilectomy surgery.
What is the difference between Cheilectomy and Bunion Surgery?
This is a point of confusion for many people. Both surgeries involve removing extra bone fragments. But the main difference is where those bone fragments are located .
- Cheilectomy: This involves removing the bone spurs that form over the joint of the big toe. This is a surgery performed for the condition of Hallux Rigidus.
- Bunion Surgery (Bunionectomy): A bunion (`(Hallux Valgus)`) is a bony protrusion on the side of the big toe joint, that is, the side opposite the other toes. So, this surgery removes the bump on that side.
Think of it this way: Cheilectomy is like removing extra weight from the roof of the joint, while Bunionectomy is like removing a protrusion from the side wall of the joint.
What happens before and during the surgery?
After deciding to have surgery, the doctor will examine your foot carefully. They will check how far you can bend your toe (range of motion). They will also take an X-ray to see clearly the condition of the joint and the position of the bone spurs.
On the day of the surgery, you will be given anesthesia. Then, the surgeon will make a small incision on the top of your foot, just above the big toe joint, and carefully remove the extra bone spurs that are causing the pain and stiffness.
Cheilectomy surgery can be performed in two main ways:
| Type of surgery | How it happens |
|---|---|
| Open Cheilectomy | In this, a single long incision is made, the joint is opened, and the bone fragments are removed. |
| Minimally Invasive Cheilectomy | In this method, instead of one large incision, several very small incisions are made, and a special instrument called a 'burr' is inserted through them to crush and remove the bone spurs. This method can reduce healing time. |
What happens after the surgery? And how long will it take to recover?
This is usually an outpatient surgery . This means you can go home the same day. After the surgery, you will need to wear a special shoe for a few weeks while your foot heals. This is to prevent unnecessary weight from being placed on the healing joint.
To control the pain, your doctor will prescribe a painkiller like `Paracetamol` or `Ibuprofen`.
Recovery time varies from person to person. Swelling in the foot may last for several weeks or even months. It usually takes about a month or two to return to work. However, if your job requires a lot of walking or standing, it may take a little longer. Your doctor will advise you on this.
What are the benefits and possible risks of this surgery?
Advantages
Many people experience almost complete pain relief after this surgery. They can also bend and straighten the big toe joint better than before. This makes walking and everyday activities easier.
Risks and complications
As with any surgery, there are some risks involved.
- Some people may still have some pain when moving their finger after surgery.
- An infection or scar may develop at the incision site.
- Hallux Rigidus can become more severe.
- You may experience pain in the ball of your foot, on the bottom of your foot.
- Very rarely, you may need to have another surgery, for example, a joint fusion (arthrodesis).
Don't be afraid of these risks. Your doctor will explain everything to you. The most important thing is to follow the doctor's instructions exactly after the surgery.
When to see a doctor as soon as possible
When you go home after surgery, be on the lookout for these symptoms. If you have any of these, call your doctor immediately or go to the hospital where you received treatment.
- The skin around the incision becomes dark red .
- Severe swelling .
- A pus-like fluid oozes from the cut.
- Having unbearable pain or fever.
These can be signs of an infection, so it's important to seek treatment quickly.
Take-Home Message
- Hallux Rigidus is an arthritis condition that occurs in the big toe joint. This causes extra bone spurs to form, causing pain and stiffness.
- Cheilectomy is a surgery that removes these extra bone spurs and allows the joint to move freely again.
- This surgery can reduce pain and make life easier for many people.
- It is very important to follow the doctor's instructions (such as wearing special shoes and resting) carefully during the recovery period after surgery.
- If you notice any unusual symptoms, such as severe redness, swelling, or pus around the incision, see your doctor immediately.
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