Humans are able to do many wonderful things in life for themselves and for others. This is thanks to the body system that has enabled humans to perform many activities. Have you ever wondered what will happen if your limb does not function properly? We will have a hard time doing things as we used to. In this DoctorOnCall’s article, we will learn about cheilectomy, a procedure that can eliminate problems with limb issues.
Cheilectomy is a kind of surgery that involves removal of the bony lump over the main joint of the big toe. Cheilectomy is needed in most cases involving arthritis or inflammation of the joint, specifically the great toe. In medical terms, this condition is known as hallux rigidus. Before we go further on with cheilectomy, you may know a bit more on hallux rigidus first.
Hallux rigidus is the stiffness to the base of the big toe. It is the most common arthritis condition affecting food. People with hallux rigidus often find walking is difficult or painful. Most patients develop this condition around the age of 30 to 60 years old. Hallux rigidus occurs when the cartilage covering the joint is damaged and overgrowth of bone spur to make up for the loss of the cartilage. The overgrowth causes restriction to bending of the toes needed for walking. Hallux rigidus can be caused by injury to the big toe, poor foot alignment such as bunion and flatfoot or can be caused by simple wear and tear. Main symptoms for hallux rigidus is the difficulty to bend the toe up and down. Others include presence of bump over the foot or swelling and patients tend to walk on the outside of their foot.
Doctors typically recommend cheilectomy for mild to moderate cases of hallux rigidus. Specifically, surgery is often considered when conservative treatment is unable to alleviate the pain and stiffness when wearing shoes or patients start to feel limitation in performing daily activities. This surgery procedure removes the bone spurs to create space for the toe to bend. This procedure is normally done as a day case procedure with localised anaesthesia to the foot. There will be no metal, implant or other hardware needed to be placed inside the foot. After surgery, soft dressing is used to protect the foot. Foot and ankle will be elevated for a few days as a means to mitigate swelling. Patients should be able to stand on their feet almost immediately after surgery but should be wearing walking boots or a special postoperative shoe provided. Patients should be able to wear regular shoes around 2 to 4 weeks following the surgery.
For severe cases or significant stiffness of hallux rigidus, particularly in active people, surgeons may recommend joint fusion (arthrodesis) instead. This procedure removes surfaces of the joint and fuse the two bones together in a fixed place. This may include wires, screws, pins or plates to hold the bones in place. Patients usually need rocker-type soles to walk.
One of the common questions asked by patients is if they can run after cheilectomy. In most cases, patients should be able to run after week 4 or 6 following cheilectomy. In general, walking is allowed as soon as the sutures are removed but it would be uncomfortable for a while until 6-12 weeks after the procedure. Full recovery from foot surgery may take from 3 to 6 months, at times even longer. The best way to know if patients are able to run or not soon after cheilectomy, is to ensure they have gotten medical approval from their healthcare provider such as a podiatrist.
Even if a person thinks they are already ready to run, they should ensure they do not rush back to achieve distances or speed they used to prior undergoing surgery. Patients might want to consider following a modified training program first as recommended by healthcare professionals. This will allow the body to have enough time to recover from running in the program and provide a means of protecting the feet from repeated injury. Patients are also recommended to warm up longer than before, such as brisk walk first and build up to jog first before proceeding to run.
In essence, cheilectomy is a common procedure done to alleviate symptoms in those with hallux rigidus. Surgery for hallux rigidus is done when conservative treatment is unable to help patients feel better or when patients are unable to carry on with their daily life routine. Patients should be able to return to their normal exercise and activities after around 3 months. However, slight swelling may still be presence for almost 12 months. Patients who intend to run need to understand that they have to get medical approval or discuss with their doctor first. Reports show that most people do well with cheilectomy for more than 10 years despite some patients may end up needing joint fusion surgery.