Big Toe Joint Fusion Recovery Time: Surgery & Best Treatment 2019

Big toe joint fusion recovery time is generally 2-3 weeks of sutures, surgical dressing and shoe. Then a good running shoe for 6-8 weeks.



Big Toe Joint Fusion Recovery Time Overview:


bone spur on top of the foot hallux rigidus bone spur with arthritis surgery treatment, hallux rigidus
This is an example of a patient who has really bad arthritis and heel spurs to the back of the heel bone. They also have a gigantic spur on top of the foot, which is at the big toe joint. In this case. This is a very difficult foot to deal with, and this patient could not even fit into a shoe. This did require surgery.


The length of recovery time depends on the surgeon’s confidence in your ability to heal. For example someone with diabetes that is a smoker will have a much longer healing time than a fit 20 year old athlete.


The best case scenario is approximately 2-3 weeks in a CAM walker or a cast, then a couple weeks in a good supportive running shoe until the  surgeon can see the bone fusing together on X-ray during a checkup visit. It can take 6-8 weeks until you start to feel better than you did before the surgery.


Big Toe Joint Fusion Recovery Time
This a fracture of both the great toe and the 5th metatarsal. The big toe joint fusion recovery time on this patient was 4 weeks in a surgical shoe and bulky dressing, then a protective shoe for 4 more weeks.



Bone Spur on Top of the Foot Surgery Recovery Time Protocol:

This guide will detail the length of specific step by step bone spur surgery recovery time.


1st MTPJ fusion healing time fluoroscopy surgery correction
This patient with a metatarsal phalangeal joint fusion had a recovery time of 1 month in a surgical shoe and dressing. Sutures came out at 3 weeks. The patient was then walking for 4 weeks.


Big Toe Joint Healing Time:


Day 1: Top of the Foot Spur Removal Surgery Day:

  • The actually surgery takes well under an hour, and your foot is usually numbed up for the rest of the day.
  • Some people don’t need much if any pain medication outside of anti-inflammatories. If you do have pain to this site, then it is normal to have a prescription for a narcotic pain medication for the days immediately after the surgery.
  • After surgery you will wake up with a dressing on your foot. Keep this dressing in place and your pain will be well under control with medication.
  • No implants or bone healing is necessary, except for the healing of bone pain.
  • You can wear a boot over your dressing almost immediately.
  • Most physically able people do not need crutches or a walker unless they have other health issues.
  • Usually there are about 2 sutures in the foot.
hallux rigidus big toe joint spur surgery
This is an example hallux rigidus or really bad arthritis formation in the big toe joint. Procedure like this needs. The bone removed, as well as the potential fusion of the joint.



Day 7:  Top of the Foot Bone Spur Removal Surgery Postoperative Visit #1:

  • Within about a week, we have the first postoperative visit.
  • You will have an X-ray at this visit and we will make sure there is no irritation or damage to your dressing.
  • With this dressing change some antibiotic ointment is applied, we make sure you are not having any problems at this time.
  • Sutures are not removed yet at this visit.
The incision site will stay covered with the stitches in place following the surgery.

big toe joint fusion great toe joint fusion
On these x-rays, the play in the screws look huge. We have to remember that this is a very thin plate, it is extremely rare for patients to ever feel this plate. I would say that only about 5% of the time in very thin patients do people feel this plate. These are walking screws, so they rarely if ever back out.


Week 2-3: Top of the Foot Bone Spur Removal Surgery Postoperative Visit #2:

  • This can fluctuate depending your overall health needs, physical fitness and life needs.
  • If you are able to rest more, weight less and are really healthy, sutures can usually come out at 2 weeks. Some patients need to walk and be more active, if this is the case you will likely need sutures longer and have a larger dressing.
  • If you swell more and are more tender, they can stay in a little bit longer.
  • If you are a smoker or have decreased healing ability, we may need to keep your sutures in place longer.
  • At this point your incision site should be healed.
  • At this point you will wear a band-aid for 2 weeks and walk in a good supportive running shoe.


big toe joint hallux IPJ fusion surgery treatment hallux
This is technically a great toe joint fusion. But this is a fusion of the IPG joint, it is not a fusion of the metatarsal phalangeal joint. There are actually cases of NFL running backs playing while having the screw in their big toe joint! That’s how well you can move after one of these surgeries.


Week 5: Postoperative Visit #3:

  • This is what the incision site will look like after the sutures are removed at 2-3 weeks or so.
  • If everything looks good, you no longer need to wear a band-aid.
  • At this point you will still be sore but can transition back into


bilateral big toe joint fusion for halllux rigidus bunion
This is an example of a bilateral screw based MTPJ fusion patient. This patient had it done many many years ago when plates were not the standard. The downside of this approach is that you have to protect a little bit longer at the beginning. But the end result is just as good!


2 Months: Postoperative Visit #4:

  • At this point you continue wearing a good supportive orthotic and good shoe.
  • If everything is feeling well you should be close to healed.
  • Keep in mind that you will continue improving for about 6 months total. But at this point you should be feeling better than you did prior to when you have a heel spur.
  • Congratulations you


big toe joint fusion with a plate 1st MTPJ fusion
This is an example of a six hole plate with one crossing screw. This procedure was performed for hallux rigidus, which is end-stage big toe joint arthritis. This is different than a really bad bunion, this is when you have really bad arthritis.


What Can Speed Up Healing Time in Big Toe Joint Fusion Surgery?

There are many things that can make you heal much quicker.


A)How much do you weigh?


  • A 350lbs person may have a slightly harder time walking on his or her big toe joint fusion site than a 100lbs person.
  • Generally the smaller and lighter someone is, all things being considered equal, they can walk much quicker with better relief of pain.
  • The more athletic and strong you are in the rest of your body, generally the better you can keep weight off the front of the foot while it continues improves.


B)How much walking do you need to do after a surgery?:


  • Someone who is a computer programmer clearly needs to stand or walk less than a nurse at a hospital for example.  This causes less damage to the surgical site while it is healing.
  • For example: If you have kids and need to check on them every 5 minutes, odds are you will be much more sore after the surgery than someone who can sit and watch Netflix all week long and relax with the foot elevated.
  • In summary: the less you walk on your feet, the faster the big toe fusion site will heal after the surgery.
  • These types of changes can sometimes improve healing time by even up to 50% difference based on our experience.


Pros and Cons 1st MTPJ metatarsal phalangeal joint fusion of the big toe joint
There are pros and cons to a first MTPJ fusion. The pros are that it is very predictable procedure that will get rid of your pain! This leads to excellent overall results. The downsides are you will never be able to bend your big toe joint again. But in most cases, if you’re considering this procedure, you probably can’t bend your big toe joint anyway.



C)How healthy and physically fit are you?


  • Patients who can barely walk and have decreased overall muscle tone and strength before surgery, generally have a hard time walking after surgery.
  • A de-conditioned patient mare require significant physical therapy after the surgery to build up their muscle tone. Your big toe joint pain can be only one component of your difficulty walking and moving.
  • This means if you can’t support yourself on crutches or a knee scooter, you may be unable to walk after surgery without causing constant irritation to the foot.
  • In general, someone who is more light and fit will have a harder time walking and moving.



Big Toe Joint Healing Summary:


How to Speed Up Joint Fusion Recovery Time:

  • Keep the joint complete non-weight bearing.
  • Stop Smoking.
  • Get lots of rest.
  • Take the pain medication that your podiatrist gives you.


How to Slow Down your Joint Fusion Recovery Time:

  • The main this is people who walk on it, it may not seem like much but the micromotion really inflames and irritates the joint and wound site leading to infections and major increases in healing time.
  • Just stay off your foot no matter what, you are just making the entire process longer and you will eventually have to keep off of it anyway!



Consider hallux rigidus surgery:

This is our video guide on hallux rigidus treatment:

More of 1st MTPJ fusion: Link