Instructions for after your MTP Joint Fusion Surgery


In the First 24 Hours

Try and keep your leg elevated. The foot should be above the level of your hip as much as possible.

Take regular pain relief. Paracetamol and an anti-inflammatory (like Voltaren) are the best combination for pain relief. Occasionally stronger pain relief may be required but should be used only for a couple of days if possible.

The pain will increase when the local anaesthetic wears off (usually around 6-8 hours) so take the pain relief before it gets too sore.

If the cast is too tight then this can be released. But the problem is usually a lack of elevation so try this first.

Cast Overwrap and Walking Aids

The cast will be over wrapped with synthetic cast at the time of the surgery. This combined with a cast shoe should allow you to fully weightbear. Generally weightbearing however is taken through the heel and outside the border of the foot to avoid pressure over the fusion site.

You will require crutches initially and will be able to heel weightbear.

Cast Changes

Most patients will be in a slipper cast for the first six weeks. This will generally be changed at two to three weeks following surgery to check that the wounds are well healed and to allow for a more supportive cast to be applied. Occasionally patients may be in a surgical shoe.

Discharge from Hospital

Most patients will have this surgery performed as an outpatient but occasionally patients will stay one night in hospital. If so the nurses will help you with instructions on mobility and simple daily activities such as showering etc before you go.

Stitches or Sutures

The sutures are dissolvable and are all under the skin, so will not need to be removed.

The First Week

Continue with regular pain relief. Try and avoid anti-inflammatories (such as Diclofenac/Voltaren, Ibuprofen etc) after you leave the hospital as this can slow down the bone healing.

Elevation is still very important. Swelling from excessive standing or sitting puts pressure on the wounds causing pain and increasing the chance of a wound complication such as an infection etc.

Gradually increase your activity after the first week.

What to Watch Out For

If you have concerns in the first few days after discharge, you can call Manuka Street Hospital on (03) 548 8566 for advice. Staff are on the ward 24 hours of the day.

If you develop calf pain, chest pain, shortness of breath then you need to either see your GP promptly or be seen in an Emergency Clinic/Hospital.

Follow-up Appointment

You should be provided with an appointment time for follow-up around 2 to 3 weeks followingyour surgery.

If you have any concerns or need to alter your appointment please contact Mr Peterson’s rooms on (03) 539 0988. Your follow-up will be at the Collingwood Centre, level 1, 105 Collingwood St, Nelson.

 Click here to download the instructions as a pdf