What is Ostectomy of the Foot

Ostectomy of the foot is a surgery to remove part of a bone in the foot. You may need this procedure if:

• You have an abnormal bone growth called a bone spur (osteophyte) in your foot.
• Bones in your foot are not lined up with each other (misalignment).

The procedure may be done if one of these conditions is causing pain or limiting movement. It is usually done when other treatments have not helped. During an ostectomy, part of the bone is removed to shorten or reshape the bone.

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.
• Whether you are pregnant or may be pregnant.

What are the risks?

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

• Infection.
• Bleeding.
• Pain.
• Stiffness.
• Numbness.
• Allergic reactions to medicines.
• Damage to nerves or blood vessels in the foot.
• A blood clot that forms in the leg and travels to the lung.
• Failure of the bone to heal.
• The abnormal bone growth coming back again (recurrence).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• 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.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• You may have foot X-rays done while you are standing on your foot. This allows the surgeon to clearly see the abnormal bone growth in your foot.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To lower 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.
• 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).
• An incision will be made in your foot.
• Tissues, nerves, and blood vessels near the bone will be moved out of the way.
• The spur or the part of bone that needs to be removed will be cut away using a bone saw or a bone shaving instrument.
• The remaining bone may be secured with screws, wires, or plates.
• The skin incision will be closed with stitches (sutures) or another type of skin closure.
• A bandage (dressing) will be placed over the incision.
• A soft wrap may be placed around 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 until the medicines you were given have worn off.
• Your foot may be placed in a protective shoe, a splint, or a cast.
• You may be given crutches or a walker to help you walk without putting weight (bearing weight) on your foot.
• Do not drive for 24 hours if you were given a sedative.

Summary

• Ostectomy of the foot is a surgery to remove part of a bone in the foot.
• You may need this procedure if you have an abnormal bone growth called a bone spur (osteophyte) or if bones in your foot are not lined up with each other (misalignment). The procedure may be done if you have pain or limited movement and other treatments have not helped.
• Follow instructions from your health care provider about eating and drinking before the procedure.
• After the procedure, your foot may be placed in a protective shoe, a splint, or a cast. You may be given crutches or a walker to help you walk without putting weight (bearing weight) on your foot.

Ostectomy of the Foot, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Swelling.
• Stiffness.

Follow these instructions at home:

If you have a splint or supportive shoe:

• Wear the splint or shoe as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint or shoe if your toes tingle, become numb, or turn cold and blue.
• Keep the splint or shoe clean.
• If the splint or shoe is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Tell your health care provider about any concerns.
• You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
• Keep the cast clean.
• If the cast is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths for bathing.
• If your cast or splint is not waterproof, cover it with a watertight covering 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 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:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, put ice on the affected area.
  • If you have a removable splint or shoe, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag or between your cast and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your foot and toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) your foot area above the level of your heart while you are sitting or lying down.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive if you have a cast, splint, or supportive shoe on your foot.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises as told by your health care provider.

Safety

• Do not use your foot to support your body weight until your health care provider says that you can.
• Use your crutches or walker as told by your health care provider.

General instructions

• Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These 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 chills or a fever.
• Your pain is not controlled by your pain medicine.
• You have redness, swelling, or pain around your incision.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.

Get help right away if:

• You have severe pain.
• You have new pain, warmth, and swelling in your leg.
• You have chest pain or difficulty breathing.

Summary

• After the procedure, it is common to have some pain, swelling, and stiffness.
• Follow instructions from your health care provider about how to take care of your incision. Check the incision area every day for signs of infection.
• Do not use your foot to support your body weight until your health care provider says that you can.
• Move your foot and toes often to avoid stiffness and to lessen swelling.