Big toe cheilectomy

Big toe cheilectomy is an operation to remove the bony lumps that can be found on the top of the big toe joint that is caused by arthritis. The operation can help relieve the pain caused by your shoe pressing on the bony lump and also improve the range of movement of the toe. In general, the operation is more successful in cases where there is mild to moderate arthritis (rather than advanced arthritis) of the big toe joint.

Big toe cheilectomy is usually performed under general anaesthetic as a day-case procedure. A cut is made on the side of your big toe. The surgeon will then remove the bony prominences around the toe. The incisions are closed with stitches or adhesive strips.

After the operation, you will have a bandage 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. 

A big toe cheilectomy 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 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 small nerves around the operation site leading to numbness or pain in the big toe - this usually settles on its own. 
  • The big toe joint remains stiff and painful. This may happen in individual cases when there is significant arthritis in the big toe joint.  

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Circle Health Group, 1st Floor, 30 Cannon Street, London, EC4M 6XH