Cheilectomy
What is cheilectomy?
You have haliux rigidus and probably don%26rsquo;t know anything about the treatment. The only thing you know is that your doctor suggested you a cheilectomy. You are wondering what to do, and worry about the surgery. We can help you. Everything you should know about cheilectomy, you will find here, but if you have any concerns about surgery talk with your surgeon! Your surgeon is familiar with your case, and he will know what is best for you!
First you should know that cheilectomy is a surgery to remove a bony lump on the top of the main joint of the big toe. This problem is almost always caused by arthritis of the great toe. Cheilectomy increases joint movement, and is successful in reducing symptoms in patients with less severe arthritis.
Reasons for Cheilectomy
First reason why Cheilectomy is done is because the bony lump is pressing painfully on your shoes. The reason for this surgery is a treatment for early arthritis of the big toe, when the joint is not yet badly affected. Most common indications for cheilectomy are hallux rigidus in grade I or grade II without sesamoid disease.
You probably tried different shoes, before you went to surgeon. If arthritis is the main problem, Cheilectomy would only be advised if other treatments which include anti-inflammatory drugs, modifications to your shoes and injections had not helped.
How is the surgery performed?
You shouldn%26rsquo;t eat, drink or smoke for 6 hours prior to surgery. Surgeon made cut over the lump on the big toe.
When the lump is removed then the joint flushed out. The joint must be checked to find out how bad your arthritis is. When this done the joint is stitched up and dressings are applied.
How long you will stay in hospital?
If you are healthy, have someone to help you after the operation, the operation can be done on a day case basis.
But, if you have some chronic disease such as diabetes, asthma or high blood pressure, you must stay in hospital a day before operation, and day after operation.
Another reason for having to stay overnight after a cheilectomy is for pain control, because operation involves cutting out a piece of bone. You will have pain immediately after surgery. Local anesthetic injections can help with pain. The most of people who have a cheilectomy are able to go home the same day.
Will you have general anesthetic?
Cheilectomy can be done under general anesthetic. But, also can be done while the patient remains awake. An injection in the back, leg or around the ankle can be done to make the foot numb. You should know that sometimes local anesthetic injections aren%26rsquo;t enough, and you may need general anesthetic. Anesthetist will suggest you the best anesthetic for you.
After Cheilectomy is done what happen?
After surgery is done you will have a firm bandage. After surgery the foot is always painful, but it is usually possible to control the pain with medication. Next morning after the operation you should remove the bandage and put an Elastoplast-type dressing over the wound. Surgeon will explain to you how to stretch your big toe up and down gently. This can be painful but it is very important to get your toe moving early, as the toe heals you should work harder and harder at it. Keep your foot elevated at the level your heart as much as possible first two week after your surgery.
Doctor will tell you when you will come back to the clinic, approximately 1-2 weeks after the surgery. He will check your wound and advice you how to exercise. You will have another check-up about 6-8 weeks after your operation and if everything is all right you need not come back.
If you have arthritis you will have some improve, pain relief within a month. If the operation was done for arthritis, you will probably notice an improvement in the arthritic pain within a month. With cheilectomy there is usually an increase in the movement in the joint of about 20 degrees.
It is important that you inform a doctor if you get an increase in pain after you go home, if the painkillers don%26rsquo;t help, this may indicate early infection. If you get swelling of the leg or foot which does not despair when the foot is elevated above heart level you should inform your doctor.
How soon can I walk, work?
After, surgery first two week, skin should heal. Surgeon will advise you to start exercise and start the joint moving. You should take this serious; you must exercise early and regularly. This will help you to have the best result from your surgery. You can walk right away after operation. Walking helps you to avoid stiffness. You must avoid swelling when you don%26rsquo;t actually walking. When you will get back to work that depend witch kind of job do you have. If you have sitting down job you can back a few days after surgery. But, if you have a heavy manual job you may be off work more than 3 months. Your doctor will tell you when you will able to drive. Usually this is 2-4 weeks after surgery. It is important to know if you cannot safely make an emergency stop your insurance will not cover you in the event of an accident. When you start to drive again don%26rsquo;t drive long distances.
When you can run, exercise?
Bed for the first two to three days with your foot elevated above the level of the heart, foot should be elevated on 3 to 4 pillows. Your doctor will give advice how to elevate your foot. You must supply with post %26ndash; operative shoe which you will wear for 6 weeks.
You can start exercising your foot and walking further each day, as the swelling in your foot goes down. You must be careful! When you are comfortable doing this you can start gentle running and stretching. Contact, twisting and impact sports can follow as comfort dictates. Everyone is different in how quickly they can take up exercise again: be guided by your own body's reactions and the advice of your surgeon. Most people can get back to most of their previous activities within 6 months of a cheilectomy.
What are possible complications of cheilectomy?
Cheilectomy produces good results in most cases, but complications do occur. You can reduce the risk of complications by preparing yourself and your foot before surgery. You can have some discharge from the wound, because you exercise. I f you worry ask your doctor about that. Damage to the small nerves and blood vessels, which are stretched, can cause numbness or tingling on top of the big toe. If you have arthritis in the joint, this may progress over the next few years and you may eventually need further treatment. The weight transfer to the second toe also can occur as the complication of the surgery. After this surgery patients can suffer with persisting stiffness, or the arthritis can progress. Every surgery care potential risk of infection. The complications of any surgery are complications such as thrombosis and anesthetic problems.
Most complication can be treated by medications, therapy and sometimes by further surgery. Cheilectomy surgery shouldn%26rsquo;t be done for cosmetic reasons only. Symptoms you have before surgery must be worth the risk of these complications. Surgery shouldn%26rsquo;t be done to avoid problems that are not yet present. You must talk with your doctor about the potential risk of the operation, if you have any worries you should ask the doctor who will explain it to you. Dependent upon the nature of the disease, the results varied with the most beneficial results in the early stages of hallux rigidus, which include symptoms, re-operation, and range of motion.
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