First MTPJ (Big Toe) Fusion

Indications for operation

Arthritis of the big toe.


The operation will be performed while you're asleep under a general anaesthetic.

Operation type



An incision approximately 6-7cm long is made over the big toe joint on the inside of the foot.


The joint of the big toe is inspected to ascertain exactly how much damage there is to the surface. All of the excess bone spurs are shaved away to improve the shape of the toe. The surfaces of both sides of the joint are removed to expose the healthy bone underneath. This bone can heal in the same way as a broken bone. The toe is then placed in the position that will be most useful (usually fractionally off the floor) and held there with some screws. A plate and screws may also be used if the bone does not seem very strong.

Wound closure

The wound is closed with absorbable stitches.


Dressings are placed over the stitches and a supportive dressing applied to the foot and big toe.

Immediate aftercare

You will be able to get out of bed as soon as you are comfortable and given a shoe that allows you to walk on the foot when you feel ready. Then, once your surgeon and anaesthetist are happy you'll be given an outpatient's appointment and allowed to return home. You must leave the dressing alone until you are seen in the clinic at about two weeks.

It is important to keep the leg elevated the first few weeks to reduce the swelling. The swelling commonly continues for 6 months and is nothing to be concerned about.


All operations carry small risks of complications. Whilst these are very rare, they need to be balanced against the potential benefits and this is something that your surgeon will discuss with you in detail before the operation. The specific risks for first MTPJ fusion are are wound infection, failure of the bone to join together, injury to a small nerve, discomfort related to the screws, discomfort in other parts of the foot.

Our practice covers the following hospitals:

Parkside Hospital
For appointments phone : 0208 971 8026

St Anthony's Hospital
For appointments phone : 0208 335 4678

Ashtead Hospital
For appointments phone : 01372 221441

New Victoria Hospital
For appointments phone : 0208 9499000

Clock House Hospital
For appointments phone : 01372 840837