Big toe arthritis
Adelaide
What are the symptoms of arthritis in the big toe?
If you notice these symptoms, consulting a specialist can help address the condition and prevent it from worsening.
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Bony bump on top of the foot
- A visible bony prominence forms at the base of the big toe that can restrict movement and cause pain.
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Pain and swelling of the toe
- Discomfort around the joint, especially when walking/running or wearing tight shoes. The area on top of the toe joint may get inflamed and swollen.
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Restricted movement
- Limited mobility in the big toe makes it harder to walk and run comfortably. Climbing stairs and ladders may also be uncomfortable.
What does surgery for arthritis of the big toe involve?
Early involvement of the big toe with arthritis can cause a painful limitation of movement, and surgical removal of bony bumps can improve this pain and restore movement. This procedure can be done through a minimally invasive procedure or a small cut on top of the toe.
Moderate to severe involvement of the joint usually requires a permanent fusion procedure. The big toe is fixed in position using a plate and screws. The result is a stiff but painless toe!
What are the risks associated with toe surgery?
Swelling
Swelling is common after most foot surgery. This can be minimised by rest, elevation immediately after surgery.
Infections
Infection after surgery (reduced risk with keyhole and minimally invasive techniques) can be prevented by ensuring that you keep your foot dry, rested and elevated as much as possible in the first three to four weeks after surgery. Feet are closer to the ground and tend to swell more than other areas of the body. Feet and shoes are colonised with bacteria that can flourish in wet conditions and around fresh bleeding wounds.
Recurrence of symptoms
Toe deformities can come back after surgery. This depends on many factors like shoe wear, strong genetic history and the age at which you have surgery. Having surgery at a younger age may result in other deformities of toes that have been previously fused.
Deep Vein Thrombosis (DVTs)
The risk of deep vein thrombosis is very low after foot surgery because you are able to bear weight on your foot.
Joint Stiffness
Toe surgery will result in permanent stiffness of the toes at the small joints that have been fused. The larger joint closer to the middle of the foot remains mobile and must be exercised immediately after surgery to avoid further stiffness of the corrected toe.
Scarring around surgical wounds
All keyhole and minimally invasive surgeries will leave you with a scar. These are generally smaller and heal well with control of foot swelling and scar therapy. Unlike other areas of the body (face, hands), we advise patients to avoid manipulating or massaging a foot scar until it is well healed (usually around five to six weeks following foot and ankle surgery).
Big toe fusion surgery aftercare
General post-operative and wound care instructions will be emailed to you before your surgery. These documents also contain the date and time of your first appointment after surgery.
Dressings
Your foot and ankle will be heavily bandaged after surgery. These bandages are necessary to prevent bleeding after surgery. It is advisable to keep the foot dry, rested and elevated in the first three to four weeks after surgery. This requires you to seal the area when taking quick showers. Frequent change of dressings and getting your dressings wet and dirty may predispose you to an infection. We strongly discourage dressing changes at home.
A wound care document is emailed to you along with all your preoperative paperwork.
Postoperative wound care is our priority. Following our instructions will ensure that all your wounds heal well. You are encouraged to call or email us to ask for advice or to discuss any concerns around wound care.
Shoes and mobility aids
You will be allowed to walk in a hospital-grade post-operative shoe immediately after surgery. It is advisable to use this shoe when walking in your home as well as outdoors. A moon boot is usually not necessary after toe surgery. You may take the shoe off in bed. We allow you to bear full weight on your foot (as long as you are in the post-operative shoe), and you are not required to bear weight through your heel. A walking stick may be helpful in the first few weeks after surgery. Failure to use the post-operative shoe may result in delayed bone healing.
Early ROM exercises and rehabilitation are encouraged in order to get the best outcome following surgery. You may continue upper body and abdominal strengthening as well as straight leg raising (SLR) exercises while recovering from your surgery.
Rest and elevation
Feet and ankles are more likely to swell after surgery. Swelling can cause a lot of pain and discomfort, requiring the use of excessive pain-relieving medication. The most reliable way of reducing immediate postoperative swelling is to keep your foot elevated above the level of the heart. Reducing physical activity can help control swelling and pain, especially in the first three to four weeks after surgery.
Blood-thinning medication to prevent Deep Vein Thrombosis (DVTs)
There is limited evidence for the use of blood thinners after surgery on the feet. You are allowed to bear full weight on your foot after surgery, thus reducing the incidence of postoperative deep vein thrombotic events. You may be prescribed a dose of a blood-thinning medication to be taken for a specified duration after your surgery if you have had a DVT in the past or have certain risk factors for developing DVTs. Drinking plenty of fluids and performing frequent range of motion (ROM) exercises may also prevent DVTs.
Pain medication
Our anaesthetists will provide you with adequate pain-relieving medication to take home after your surgery. The anaesthetist may also discuss having a nerve block for pain relief just before surgery. The most reliable way to reduce pain and swelling after surgery is to rest and elevate your foot as much as possible.
Prevention of infections
We give you antibiotics at the start of every operation and operate in a sterile environment after adequately cleaning and disinfecting the foot. You will be prescribed oral antibiotics upon your discharge from the hospital. Rest and elevation, using your shoe and boot and leaving all dressings dry and intact can help prevent post-operative infections.
Driving
Driving is unsafe for a minimum of six weeks following surgery and for as long as you are required to wear protective footwear, as advised by us.
Holidays and long-distance travel after surgery
It is advisable to avoid surgery if you have a planned holiday or long-distance travel plans within weeks after surgery. Please discuss these plans with us so that we can advise you on the most appropriate time to have surgery.
Relieve the symptoms of arthritis with specialist care.
Connect with our team and start your journey to recovery.
Why choose SA Foot & Ankle Surgery?
Quick bookings at multiple locations
With multiple clinic locations across Adelaide, we offer immediate availability, often seeing patients within 24 hours of receiving a referral.
Advanced care for your condition
Our specialised procedures, including advanced surgeries like ankle fusions, prioritise quicker recovery and less discomfort.
Foot and ankle specialist surgeon
Unlike general practices, we specialise exclusively in foot and ankle conditions, ensuring you receive expert care tailored to your specific needs.
Tailored treatment plans
We thoroughly assess your needs and present personalised treatment options, including non-surgical solutions where appropriate.
Patient-centred care
We take the time to explain your condition and treatment options, ensuring you’re fully involved in every decision regarding your health.
Low gap (total out-of-pocket cost) *
For most operations, your gap paid to the practice is the only out of pocket cost for surgery, without additional or hidden costs. There is a separate gap payable to the anaesthetist and the surgical assistant who work alongside, but independently of Dr. Silveira.
* Complex procedures may attract additional costs that will be discussed with you at the initial consultation.
Meet Dr Gayle Silveira, the surgeon behind your care
Gayle Silveira is a fellowship-trained foot, ankle and trauma surgeon. She completed Orthopaedic training in Adelaide and is a Fellow of the Royal Australasian College of Surgeons.
Gayle gained further experience in complex surgical techniques through advanced training in foot and ankle surgery under the guidance of Dr. Simon Platt. She is proficient in keyhole surgery/minimally invasive techniques and management of sports injuries. In addition, her Master’s in Biomechanics and Sports Physiology complements her expertise in foot and ankle pathology.
Gayle is committed to offering her patients high-quality care with compassion and respect. She spends time listening to you whilst carefully formulating a tailored management plan. Her goal is to help you achieve your desired outcome.
Fellow of the Royal Australasian College of Surgeons (Orthopaedics)
Member of the Australian Foot and Ankle Society
Bachelor of Medicine and Surgery
Master's Sports Studies (Biomechanics and Sports Physiology)
Member of the American Foot and Ankle Society
