A cheilectomy is a surgical procedure for the big toe joint. Its primary aim is to alleviate discomfort and improve the range of motion, especially when bone spurs interfere with normal function. This operation treats a common foot condition that can impact daily activities.
Understanding the Procedure
A cheilectomy involves removing bone spurs, also known as osteophytes, from the first metatarsophalangeal (MTP) joint, the main joint of the big toe. This procedure aims to create more space within the joint, allowing the big toe to bend more freely. It is considered a joint-preserving procedure, as it works to maintain the natural structure and function of the toe rather than replacing or fusing the joint.
Indications for Surgery
The primary condition a cheilectomy treats is hallux rigidus, a form of arthritis affecting the big toe joint. Hallux rigidus typically causes pain, stiffness, and limited big toe movement, especially when pushing off during walking. Individuals often experience a painful bony lump or swelling on the top of the big toe joint, making shoe wear uncomfortable. This surgical intervention is considered after conservative treatments, such as shoe modifications, anti-inflammatory medications, or injections, fail to provide sufficient relief.
The Surgical Steps
A cheilectomy is typically performed under general anesthesia, though regional or local anesthesia, which numbs only the foot or leg, can also be used. The surgeon makes an incision, usually on the top of the big toe joint, to access the affected area. Through this incision, bone spurs are carefully removed using specialized surgical tools like a burr or a saw.
The procedure involves cleaning out the joint, including removing inflamed tissue or loose fragments. The goal is to reshape the bone and create enough space for the toe to move without impingement. The joint cartilage is preserved during a cheilectomy, as the focus is on removing obstructing bone rather than altering the joint surface. In some cases, a minimally invasive technique using smaller incisions may be employed, potentially leading to faster healing.
Life After Cheilectomy
Following a cheilectomy, patients wear a special surgical shoe or protective boot for several weeks to support the foot during healing. Elevating the foot and managing pain with medication are important for reducing swelling and discomfort. Physical therapy guides patients through exercises to regain motion and strength in the big toe.
Most individuals experience significant pain relief and improved mobility after the procedure. While complications are rare, they can include infection, nerve irritation leading to numbness, or persistent swelling. Continued monitoring is important as arthritis is a progressive condition.