surgery No toe amputation

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					                                                                            Mr M J Price
                                                            Consultant Podiatric Surgeon
                                                              Capio Rowley Hall Hospital
                    ABOUT YOUR OPERATION
                                     TOE AMPUTATION
Partial or total amputation may be indicated where the toe is not able to be corrected or
where just correcting the position of the toe would be a problem because there is no room
to put it in a straight position.
Toe amputations have in the past often been viewed as a procedure to be avoided at all
costs and a sign of failure. The severity of deformity and many factors are taken into
account when choosing the amputation site. Factors such as pressure on the healing
stump from adjoining toes, footwear and from the ground when walking, all have to be
considered.
In some circumstances, a single or multiple, partial or total toe amputation might the best
solution, greatly improving the use and comfort in a foot with the advantage of a very short
healing and recovery time.

Distal Tip Amputation
Very successful for distal problems of the toe and nail.




                Phalanges
                Proximal    Intermediate
                                           Shaded section
        MTP Joint      PIP joint           removed




                                                             Tip of 2nd toe amputated 3 months ago
Intermediate Amputation
Removal of the toe will be at the Proximal Interphalangeal joint or through the intermediate)
phalanx (middle Bone).

Proximal Amputation

Removal of the toe will be at the Metatarsal
Phalangeal joint. The skin incision is a teardrop
shape with the top edge over the joint between the
toes. The joint capsule and the overlying skin is
closed to cover the head of the metatarsal. The
result is very cosmetically acceptable.
Problems / Risks Associated with Amputation
Surgery
   Thickened scar and/ or tender scar -    may reduce over 12 months
   Infection (sudden increase in pain and swelling at 2 to 3 days after surgery - or     later)
   Chronic Pain – so called “Chronic Regional Pain Syndrome”
   Blood clot in the leg – Deep Vein Thrombosis




No 5       Toe Amputation September 04                                     Review 9/05
                                                                       Mr M J Price
                                                       Consultant Podiatric Surgeon
                                                         Capio Rowley Hall Hospital



                            Toe Amputation Surgery
                               Answers to Common Questions

The Operation
The operation is usually performed under a local anaesthetic, around the base of the toe
or the ankle, and most patients find this to be more comfortable than a dental injection.
The operation takes about 30 minutes, although you will be in the Day Surgery Unit for
some time before the surgery and afterwards, to allow you an opportunity to rest post
operatively.

The First 3 Days After Surgery
You will be able to stand and take weight carefully after the operation, but you must rest,
with your feet up, as much as possible. You should restrict your walking to going to the
bathroom. You can get about a little more after 3 days.

After 3 Days
About 3 to 7 days after surgery, you must attend for a redressing. The operation site will
be examined and redressed, and you will be given advice on gently increasing activity.

After 10 Days
Between 10 and 14 days the stitches are removed (or trimmed if absorbable), as the skin
will have healed. You will be unlikely to be able to return to your normal footwear just yet.
You will be advised on further increasing your activity and start bathing the foot again.

After 6 Weeks
Over the 6 weeks following surgery, the foot returns more to normal and you should be
back in normal footwear. You may return to work around this time (depending on your
work and the type of footwear in which you are allowed to return to work). For a heavy job,
return to work in less than 6 weeks would be an unrealistic expectation. Obviously other
factors such as; the severity of the deformity, tissue quality, circulation and general health
can also make a difference. Although the foot should now be comfortable and returning to
normal, there will still be noticeable swelling, particularly towards the end of the day. This
is normal and to be expected as feet and legs are very prone to swelling anyway.

After 6 Months
The residual swelling should now be slight, if not completely resolved, and you should be
getting the full benefit of the surgery.

12 Months after Surgery
The foot has by this stage stopped improving, all healing is complete.




No 5     Toe Amputation September 04                                Review 9/05

				
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