What is Metatarsal Osteotomy

Metatarsal osteotomy is a surgical procedure to correct a toe dislocation or deformity. The surgery may also help to relieve foot pain.

Your metatarsals are the five long bones that connect your toes to the rest of your foot. Osteotomy is a surgical cut into a bone to reshape and reposition the bone or joint.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Stiffness.
• Pain.
• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Nerve damage that causes numbness.
• Failure of the osteotomy to heal.
• A blood clot that forms in your leg and travels to your lungs (pulmonary embolism).

What happens before the procedure?

• Your health care provider may order imaging tests of your foot.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home after the procedure.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• An IV tube will be started in one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• A surgical cut (incision) will be made on your foot over the metatarsal bone that will be treated.
• A cut will be made in the bone to shorten or straighten the bone.
• Metal pins, plates, or screws may be used to hold the bone in the right position.
• The incision will be closed with stitches (sutures) or staples.
• A bandage (dressing) will be placed around the front and bottom of your foot.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You may be given walking aids, such as:
  • A custom-fitted hard-soled shoe that keeps weight on your heel.
  • A walking boot.
  • A splint.
  • Crutches or a walker to help you walk without putting weight on your foot.
• Do not drive for 24 hours if you received a sedative.

Metatarsal Osteotomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Soreness.
• Pain.
• Stiffness.
• Swelling.

Follow these instructions at home:

If you have a splint:

• Wear the splint as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint if your toes tingle, become numb, or turn cold and blue.
• Do not let your splint get wet if it is not waterproof.
• Keep the splint clean.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• If your splint is not waterproof, cover it with a watertight plastic bag when you take a bath or a shower.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.

Incision care

• Follow instructions from your health care provider about how to take care of your cut from surgery (incision). Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, apply ice to the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you received a sedative.
• Ask your health care provider when it is safe to drive if you have a dressing, splint, special shoe, or walking boot on your foot.

General instructions

• If you were given a splint, special shoe, or walking boot, wear it as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches or a walker as told by your health care provider.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your dressing becomes wet, loose, or stained with blood or discharge.
• You have pus or a bad smell coming from your incision or bandage.
• Your foot becomes red, swollen, or tender.
• You have pain or stiffness that does not get better or gets worse.
• You have tingling or numbness in your foot that does not get better or gets worse.

Get help right away if:

• You develop a warm and tender swelling in your leg.
• You have chest pain.
• You have trouble breathing.