Hallux Rigidus Surgery

All Hallux rigidus procedures or types of surgery are performed on an outpatient basis, so patients can go home the same day. Only patients who for health reasons need special care after surgery will stay in the hospital. However, to leave the hospital it is recommended to have a companion who is responsible for helping the recently operated patient. It is even necessary for someone to stay the first 48 postoperative hours at home with the patient.

Thanks to advances in the techniques used for the operation, as well as the development of powerful local anesthetics and pain relievers, patients feel no pain during the surgical procedure. However, it may be normal to feel intense pain the first night after surgery, and even during the second night. The amount of pain a patient may feel is difficult to measure. Some report severe pain and discomfort, while others feel almost nothing. However, the aches and pains will cease as the days go by, and they will be less if the indications for a good postoperative recovery are followed.

The estimated time to return to work after Hallux rigidus surgery is 1 to 2 months after the operation. Depending on the type of work, you can even wait until the third postoperative month. For jobs that are sedentary, the time to return to work may be less than for jobs that require more foot work. Another factor that determines the time to return to work is the speed that each patient takes to recover. Here some issues such as age, bone quality, postoperative care, if there were no complications, healing speed, etc. come into play.

As the causes of Hallux rigidus are still not fully known, a way to prevent it has not been found. However, the progress of the deformity can be attenuated by abandoning the habits that constitute risk factors, as well as carrying out activities that are favorable to the health of the joint. For example:

• Do not wear shoes that hold the foot tight and have very high heels. If they are used, the time of use should be minimized.
• Perform stretching exercises that keep the joint mobile.
• Rest with your foot raised when you feel a lot of pain.
• Go to the doctor as soon as possible if you feel the symptoms of Hallux rigidus, with the aim of starting treatment.
• Place pads that limit the movement of the affected big toe.
• Do not put too much pressure on the first metatarsophalangeal joint.
• Avoid strong blows that can damage the big toe joint.

Those who suffer from Hallux rigidus can put into practice several home remedies that promote pain relief and the symptoms of said deformity. Among the home remedies we have the following:

• Putting your foot up : During the day you can put your foot up, and the same to sleep. This prevents inflammation caused by osteoarthritis and improves blood circulation in the area.
• Rest : Resting the affected foot as much as possible will avoid pressure on the joint, and as a consequence it will relieve pain.
• Using ice packs : Ice packs or packs can be put on the affected area for 5 to 10 minutes 1 to 3 times a day, preferably at night. This remedy is not valid for patients who have circulation problems.
• Stretching exercise : The patient can do the calf stretching exercise that we will guide below. You should do this for 1 minute for each foot, at least 2 times a day, as this can relieve big toe arthritis pain. The exercise consists of standing an arm’s length away from the wall, resting the palms of the hands on the wall and taking a bent-legged step forward while keeping the back foot fully extended. The person should stretch forward as far as possible and hold the position of the back foot as long as possible. You should then switch legs and do the same.

Foot baths : Water baths with contrasting temperatures help to alleviate the inflammation caused by Hallux rigidus. The affected foot should be placed in hot water for 30 seconds and immediately transferred to cold water for another 30 seconds. This procedure will make you feel much less pain.

1. The first visit to the doctor after a Hallux rigidus surgery will be at the end of the first week of recovery. Here they will remove the bandage to clean the wound and observe how the scar has evolved. Finally they will put another bandage on you.
2. The second visit will be at the end of the second week of recovery. At that time, the bandage will be removed and the stitches will be removed from the wound.
3. Between the third and sixth month after surgery for Hallux rigidus, you should go for a review in which the evolution of the bones will be observed through an image.
4. At month 12 after surgery, you will have one last appointment with the doctor, during which, if everything has gone well, you will be discharged.

It is important to say that patients should be in contact with the specialist, to clarify any doubts regarding the recovery phases. They should also request an appointment if they suspect they are experiencing any of the types of complications that we saw above.

After surgery for Hallux rigidus, correct treatment for stiff toes is important. A few days after the operation, the mobilization of the toes should be performed. They should be smooth but constant movements. When the toes are very stiff, intense physiotherapy treatment is recommended to regain mobility. Before prescribing this treatment, the specialist will verify the degree of involvement and mobility of the same.

The operation is performed with the use of local anesthesia, which is given as injections around the ankle and behind the knee. The objective is to numb the deepest nerves, and thus avoid the pain that Hallux rigidus surgery can cause. Local anesthesia allows patients to remain awake during the procedure, but without feeling any pain. This type of anesthesia also has the advantage that the patient can eat normally until the time of surgery.

After Hallux rigidus surgery, patients return home with a medication plan designed to prevent pain, inflammation, nausea, blood clots, constipation, and other problems that may arise. The plans are personalized and adapted to the needs and health conditions of each patient. Because of this, what is prescribed for some will not work for others. Some of the most common medications are:

Ibuprofen : 600 mg every 6 hours for 3 days, to avoid pain.

Tylenol : 650 mg every 6 hours for 3 days, to avoid pain.

Oxycodone : From 5 to 15 tablets of oxycodone, to avoid pain when it is very intense.

Zofran : 4 mg every 8 hours, only if necessary, to avoid nausea.

Colace : 100 mg 3 times a day, to avoid constipation that anesthesia and opioids can cause.

Calcium Citrate : Daily intake of 1000 to 1200 mg for the first 3 months after surgery, for bone health.

Vitamin D3 : Daily intake of 1000 to 1200 IU during the first 3 months after surgery, for bone health.

Aspirin : 325 mg daily for 2-3 weeks, to prevent blood clots. If you have a predisposition or a family history of clots, more specialized medications will be prescribed.

It is normal to feel a throbbing pain for the first few days, but it can be managed with pain relievers. It is also normal to have a swollen foot, for which anti-inflammatories are prescribed. The patient should have the foot elevated and place ice packs. You may experience some tenderness in the area, which persists for several weeks. It is also normal for bruises to appear that move towards the toes that have not been operated on, which may show changes in their coloration. Some discharge is also considered normal.

In any case, the patient must be attentive to their symptoms, and if they notice any abnormality (such as a lot of pain, abundant drainage or unusual inflammation), they must contact the clinic immediately, so that the specialist can carry out the necessary measures. relevant evidence.

Hallux rigidus is degenerative arthritis of the first metatarsal joint. That is why, as long as it is not treated, the deformity will continue to develop, and with the passage of time the mobility conditions will worsen. When Hallux rigidus is not treated, either by conservative or surgical methods, the disorder will continue to progress until it reaches the maximum stage of immobility and rigidity. This causes a lot of pain and prevents patients from walking normally, thus limiting their quality of life and activities.

Untreated hallux rigidus can cause lameness and pain in the knee, hip or lower back, as well as discomfort when standing and walking.

Depending on the type of surgery that has been performed, Hallux rigidus may or may not disappear. For example, if the Hallux rigidus type of surgery preserves the joint, the damage and deformity may continue to evolve after the operation. On the other hand, if the type of surgery removes or suppresses the damaged joint, Hallux rigidus will completely disappear after surgery, but with the consequence that the finger will be completely fused and without mobility.

Many people tend to confuse Hallux rigidus with Hallux valgus. Although both conditions are deformities or disorders of the big toe, Hallux rigidus and Hallux valgus have different causes, manifestations, and developments, so they are not the same. Perhaps this confusion is due to the fact that Hallux valgus, in some cases, is a risk factor that can lead to Hallux rigidus. But this does not determine that both pathologies are the same.

Hallux valgus is also known as a bunion, and is the most common disorder of the big toe. It is due to displacement and misalignment of the bones that make up the first metatarsal joint. This causes the tip of the big toe to droop toward the second toe and the long metatarsal bone to droop toward the inside of the foot.

Instead, Hallux rigidus is the second most frequent condition of the big toe. It consists of degenerative and progressive osteoarthritis of the first metatarsal joint. Hallux rigidus is also known as osteoarthritis of the big toe. It produces pain and loss of mobility of the joint and the big toe as the deformity progresses.