28820 Amputation, toe; metatarsophalangeal joint

Name of the Procedure:

Amputation, toe; metatarsophalangeal joint

Summary:

This procedure involves the surgical removal of a toe at the metatarsophalangeal joint, where the toe joins the foot.

Purpose:

The procedure addresses severe infections, traumatic injuries, or deformities that cannot be corrected through other treatments. Goals include alleviating pain, preventing the spread of infection, and improving mobility.

Indications:

• Severe infections (e.g., osteomyelitis)
• Complications from diabetes (e.g., non-healing ulcers)
• Traumatic injury to the toe
• Severe deformity causing pain or loss of function

Preparation:

• Patients may need to fast for several hours before the procedure.
• Medication adjustments as directed by the healthcare provider.
• Basic diagnostic tests, such as blood work and imaging studies (X-ray, MRI).

Procedure Description:

1. The patient is given anesthesia—local or general— depending on the case.
2. The surgical site is sterilized, and an incision is made at the metatarsophalangeal joint.
3. The surgeon carefully removes the toe.
4. The remaining tissue is cleaned, and the incision is closed with sutures.
5. A sterile dressing is applied to the wound.

Duration:

Approximately 1 to 2 hours.

Setting:

The procedure is typically performed in a hospital operating room or a surgical center.

Personnel:

• Surgeon
• Anesthesiologist or Nurse Anesthetist
• Surgical Nurse
• Operating Room Technician

Risks and Complications:

• Infection
• Bleeding
• Blood clots
• Poor wound healing
• Phantom limb pain
• Complications from anesthesia

Benefits:

• Relief from pain
• Prevention of infection spread
• Improved ability to wear shoes and move comfortably

Recovery:

• Post-procedure pain management with prescribed medications.
• Keeping the surgical site clean and dry.
• Follow-up appointments for wound care and monitoring healing.
• Rehabilitation exercises to regain mobility.
• Recovery can take several weeks, with a gradual increase in activity levels.

Alternatives:

• Antibiotic therapy for infections.
• Conservative treatments like orthotics for deformities.
• Surgical debridement (removal of damaged tissue) without amputation.
• The alternatives vary in effectiveness depending on the underlying condition.

Patient Experience:

• Patients typically experience some pain and swelling after the procedure, manageable with medication.
• Initial difficulty in walking might be noticed, but mobility usually improves with physical therapy.
• Emotional support may be beneficial as adjusting to the loss of a toe can be challenging.