Name of the Procedure:

Phalangectomy, toe, each toe
Common Name(s): Toe Joint Removal, Toe Bone Surgery
Technical/Medical Term: Digital Phalangectomy

Summary

A phalangectomy is a surgical procedure that involves the removal of one or more of the phalanges (bones) in a toe. This is typically done to alleviate pain, correct deformities, or treat infections or tumors in the toe.

Purpose

• Medical Condition or Problem: Treats conditions like severe toe deformities, chronic pain due to arthritis, or infections and tumors in the toe.
• Goals/Expected Outcomes: The primary goal is to reduce pain and improve toe function. It can also prevent further complications related to the toe condition.

Indications

• Symptoms/Conditions: Severe pain, deformities such as hammer toe or claw toe, chronic infections, toe tumors, or complications from previous surgeries.
• Patient Criteria: Patients who have not responded to conservative treatments (e.g., medications, orthotics), those suffering from significant pain and mobility issues.

Preparation

• Pre-procedure Instructions: Patients may need to fast for 8-12 hours prior to the surgery. They should adjust certain medications as advised by their doctor.
• Diagnostic Tests: Preoperative evaluations include X-rays, blood tests, and possibly MRI to assess the toe structure.

Procedure Description

1. Anesthesia: The patient is usually given a regional or local anesthetic, and sedation may be used depending on the extent of the surgery.
2. Incision: A small incision is made over the top or side of the affected toe.
3. Bone Removal: The surgeon carefully removes the problematic phalanges bone(s).
4. Repair and Closure: The surrounding tissues are repaired if necessary, and the incision is closed with sutures. A bandage is applied to support the toe during healing.

Duration

The procedure typically takes about 30 minutes to 1 hour per toe.

Setting

The procedure is usually performed in an outpatient surgical center or a hospital outpatient department.

Personnel

• Healthcare Professionals: An orthopedic or podiatric surgeon performs the surgery, assisted by surgical nurses and a technician. An anesthesiologist or nurse anesthetist administers the anesthesia.

Risks and Complications

• Common Risks: Pain, infection, swelling, and stiffness.
• Rare Risks: Blood clots, nerve damage, non-healing of the bone, or recurrence of the original problem.
• Management: Most complications are managed with medications, physical therapy, or additional surgery if necessary.

Benefits

• Expected Benefits: Relief from chronic pain, correction of deformities, and improved foot function.
• Timeframe: Benefits are typically realized within a few weeks to a few months, depending on the extent of the surgery and individual healing rates.

Recovery

• Post-procedure Care: Keep the foot elevated and protected. Follow wound care instructions provided.
• Recovery Time: Typically, full recovery takes about 6-8 weeks. Physical activity may be limited during this time.
• Follow-up: Regular follow-up appointments are needed to monitor healing and ensure proper recovery.

Alternatives

• Other Treatments: Non-surgical options like physical therapy, orthotic devices, medications, or less invasive surgical procedures.
• Pros and Cons: Non-surgical treatments may offer relief with less risk but might not be as effective for severe conditions. Surgery is more definitive but involves greater risks and recovery time.

Patient Experience

• During the Procedure: The patient will be under anesthesia and should feel no pain during the procedure.
• After the Procedure: Some discomfort and swelling are expected. Pain is typically managed with prescribed medications, and mobility aids like crutches or a special surgical shoe may be needed temporarily.