What Is a Cheilectomy?

Medically Reviewed by Carol DerSarkissian, MD on February 29, 2024
4 min read

Cheilectomy is a procedure in which your surgeon removes extra bone on the tip of a joint in your foot called your first MTP joint. It can be done through a small incision or an even less invasive method. It is used for hallux rigidus treatment or arthritis treatment and can increase movement in your toe.

You may choose a cheilectomy if you have:

  • Hallux rigidus. Meaning “stiff toe” in Latin, this is a type of degenerative arthritis. Over time, the big toe joint gets more stiff and painful. You progressively lose mobility in this joint. There is no clear cause for hallux rigidus but overuse, injuries, genetics, osteoarthritis, and inflammatory diseases are thought to play a role. An alternative to a cheilectomy for hallux rigidus is wearing special shoes, limiting your movement, taking pain relievers, soaking your feet, and getting corticosteroid injections.
  • Arthritis. The three most common types of foot arthritis are osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis. Arthritis is a worsening condition that makes your joints swell and feel painful and warm. Depending on the type of arthritis, your symptoms and pain might be different. 
  • A painful lump. You may have a bone spur that restricts movement and causes pain. 

Often, you will only feel a slight pain for a long time. However, it often gets worse and your movement becomes limited. At this time you should seek treatment. Your doctor will help you decide if you need a cheilectomy.

Before the procedure, a blood test will check your vitamin D levels. Your doctor will also check you for infection and take a medical history.

The surgery takes about a half-hour, but you will be in the doctor’s office for the better part of the day. You may be put to sleep with anesthesia, or may be given only a localized injection to numb your foot for surgery. Then your surgeon will make a tiny incision over the top of your big toe. 

This incision will allow your surgeon to remove the excess bone that is causing you pain and that has blocked your joint. Your surgeon will close up the incision with dissolvable stitches.

Immediately after your surgery, your foot will be bandaged. The localized anesthesia will still be in effect and you won’t be able to feel your toe yet. You will then see a physical therapist who will give you padding for your shoes and advice on how to move without hurting your wound. You will usually then be discharged after you get your necessary prescriptions and make your next appointment. 

During the first couple of weeks after the cheilectomy you should: 

  • Elevate your foot as much as possible.
  • Do exercises recommended by your physical therapist but follow your doctor’s orders for other movement.
  • Expect slight bleeding from the incision site.
  • Take medications like ibuprofen (Advil, Motrin) and Voltaren.

Recovery is a slow process. You will begin by wearing hospital shoes, then shift into wide shoes. You will probably be able to wear normal shoes within six weeks of your surgery. In the first two weeks, you will need to keep your toe completely dry and shower with a waterproof wound protector. 

Usually, you will be able to get your toe thoroughly wet two weeks after surgery. After that point, you will also be free of bandages. However, you should not pick at your wound. If it becomes red, swollen, or sore, you should immediately seek medical help. 

If you have a job with a lot of manual labor, you should plan to sit out the six weeks of your recovery. During this time you should also use extreme caution while driving. Many doctors suggest taking the full six weeks before driving. 

Complications from a cheilectomy are rare during or after surgery. However, all procedures do carry some risks. The most common dangers of cheilectomies are:

  • Infection. A 1% risk. If your wound gets infected, you will treat the disease with antibiotics.
  • Nerve damage. There are small nerves around the area in the toe near the cheilectomy site. Your toe may stay numb even after the localized anesthesia from your surgery wears off. There is a less than 5 % chance that your nerve will be permanently damaged. 
  • Deep vein thrombosis. If this happens, it means that you develop blood clotting in your leg in response to your surgery. However, this is also unusual, with a less than 3% risk.