Procedure of cheilectomy in hallux rigidus

Cheilectomy is a common surgical method for treating hallux rigidus. The procedure is usually performed under general anesthesia. If there are contraindications or a high risk of narcosis, the procedure can alternatively be performed under local anesthesia.

The aim of the operation is to restore the mobility of the big toe in the best possible way. To this end, the surgeon removes new bone formations, so-called osteophytes, which have developed in the course of arthrosis. In addition, the back of the bone head at the big toe is often removed so that the patient can stretch the big toe more easily.

Overall, cheiliectomy is not a major procedure with many risks. The operation only takes a few hours and the foot can be carefully loaded again after the operation. After the operation, regular wound control with dressing changes and anti-inflammatory medication is recommended. After two weeks at the latest, wound healing is so far advanced in most patients that the bandage can be removed.

Diagnosis

As already mentioned, an X-ray of the foot is used to confirm the diagnosis of hallux rigidus. On this X-ray, the experienced physician will see a narrowed joint space and small attachments (osteophytes). In most cases, however, the typical symptoms of a hallux rigidus are already indicative: a thickening of the joint with redness and a slight to moderate overheating. Last but not least, the limitation of movement experienced by the patient must be mentioned. Often this is the reason for a visit to the doctor.

Prognosis

In its natural course – i.e. without therapeutic intervention – the hallux rigidus shows a progressive course, i.e. it gets worse and worse over time. After cheilectomy, a delayed progression of the disease is to be expected.

Unfortunately, however, it is not possible to end the disease completely. After the operation, the patient may immediately put weight on the foot again with a special shoe with a rigid sole. This will slowly increase the mobility of the operated area.From the second day after the operation, passive movements in the joint, which the patient also learns and should subsequently practice independently, are necessary and conducive to healing. After about 2-3 weeks, the patient finally changes to a softer shoe. Especially in the initial stage of hallux rigidus, cheilectomy shows excellent results and can delay further cartilage injuries for a relatively long time.