1st Metatarsophalangeal Joint Fusion

Complications

Possible undesirable results of surgery include:

  • Pain
    • There may be some residual pain in the MTP joint.
    • Arthritis may develop in the rest of the foot. This is an unavoidable risk in arthrodesis as the normal walking pattern is necessarily changed by fusion. You may develop pain in the big toe or along the outer edge of your foot.
    • Arthritis in other joints involved in walking, like the knees, hips, lower back and other foot may develop later in life.
  • Infection. All invasive procedures carry a small risk of infection. These risks are higher if you are a smoker or diabetic, and in fusion operations where screws are used.
  • Swelling.
  • Bleeding and problems with wound healing. These tend to be more common in diabetics, but are fairly rare in hallux rigidus operations.
  • Injury to nerves – Numbness or tingling can occur at the wound or in the toe. This is usually temporary but in some it may be permanent.
  • Blood clots- Deep vein thrombosis (DVT) or pulmonary embolism (PE) are rare. You will be encouraged to walk around as soon as possible after your surgery to avoid the development of DVT. If you or your family have a history please let one of your treating doctors know.
  • Nausea, drowsiness or other discomfort associated with the anaesthesia.

For more information on the general complications associated with surgery, see Complications of Surgery.

When surgery is complicated or fails, you may need follow-up surgeries.

  • Re-positioning. Research has shown that 5-10% of cases do not fuse in the exact position intended. This may be due to the position not being achieved during surgery of movement of the bones following surgery. You will not be able to wear high heels following a fusion.
  • Removal of screws. Occasionally prominent screws or screws that cause irritation may need to be removed.
  • When the bone fails to heal around the screws, revision surgery is required. This is called 'failed' fusion. Research has shown that this occurs in approximately 10% of cases but is significantly greater if you smoke.

10 May, 2012