Rheumatoid foot reconstruction

What are toe deformities?

A rheumatoid foot reconstruction refers to a toe deformity correction which will correct deformities such as claw or hammer toe. For individuals with these problems it often feels as though they are standing or walking on pebbles which can significantly reduce mobility. The aim of such surgery is to correct the deformity and therefore improve the symptoms that the deformity was causing such as pain and loss of mobility.

What does this involve?

The procedure will usually be performed under general anaesthetic and is a day-case procedure. An incision will be made over the toe deformity, and frequently a second incision is required over the base of the toe as well. The toe will then be straightened by lengthening tendons, and removing a small amount of bone from the toe. The straightened toe will then be fixed either internally by stitching tendons together, or occasionally utilising a wire. If a wire is used, it will be removed in the clinic at six weeks.

When will I recover?

At the end of the procedure, you will have a thick bandage wrapped around the foot. For the first few weeks following surgery you will need to elevate your foot as much as possible to reduce swelling. This will both make the foot more comfortable and help the wounds to heal.

You will be advised to walk on your heel for the first few weeks after which you should be able to start wearing soft shoes and putting pressure through the whole foot. The stitches will need removing two weeks following surgery. The swelling can take several months to completely settle.

What risks should I know about?

A rheumatoid foot reconstruction is a commonly performed and generally safe procedure but there are some potential complications you should be aware of.  These affect a very small percentage of patients.

  • Infection can occur although our theatres have ultra-clean air operating conditions keeping infection rates to the minimum.
  • Blood clots are possible after any operation and are more common in patients with some pre-existing medical conditions. However, again they affect a very small percentage of patients and have well established treatments including aspirin.
  • Very rarely, damage to the nerves around the ankle and foot leading to numbness, pain and in some cases weakness in the foot - this usually settles on its own. 
  • The foot reconstruction may fail/ not give rise to the intended benefits of reduced pain and increased mobility.

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