Foot + Ankle Problems + Treatments

Big Toe Arthritis

Type of Procedure: Outpatient
Length of Procedure: 1 hour
Anesthesia: General or IV sedation with nerve block

Fusion of the Hallux MTP joint:

The purpose of this procedure is to eliminate this painful joint of the hallux (big toe), the cause of which is most typically arthritis. It is also performed to remove the painful bump (spur) on the top of the joint, and to correct deformity.

You can also book an appointment by calling Dr. Carreira’s office at 404-355-0743. Learn more at

Once fused, the big toe does not move except at the end joint (interphalangeal joint).

Once fusion is successful, you will be able to wear most shoes, including a heel of up to approximately 1.5 inches.

Because the joint is locked into place, the joint is typically stiff after surgery. With the exception of high performance athletes, this should not cause any functional difference. The most significant difference is in the large improvement or complete elimination of pain.


You are able to walk on the foot the day after surgery in a special Darco wedge shoe.

You must wear your surgical shoe at all times until the joint is fused. If you would like a different shoe for sleeping, please request one.

You may not walk bare foot at all until approximately 6 weeks after surgery.

You may drive as soon as comfortable, usually at 3 days if the left foot and 7 days for the right foot. For driving you will need a postoperative shoe, only to be used for driving and sleeping. Test your driving in a parking lot first.

Specific Post Operative Course

Day 1

  • Foot wrapped in bulky bandage and Darco wedge shoe
  • Ice, elevate, and take pain medication
  • Expect numbness in the foot for 12 24 hours
  • Expect bloody drainage through bandage. You may add dressing, but do not change bandage for two to three days
  • Wear a postoperative shoe (different from Darco shoe) at night

Day 3

Start walking on the heel and outside of foot in Darco wedge shoe only
Ice, elevate as much as possible.

2 weeks

  • First follow-up visit
  • X-rays will be obtained in the office
  • Sutures likely removed
  • Shower as long as the incision is healed

6 weeks

  • Remove surgical shoe
  • X-rays obtained to check bone healing
  • A stiff soled shoe is important for one to two more months