How effective is joint fusion surgery for hallux rigidus?

The operation joins the bones on either side of the painful big-toe joint so they heal as one stable unit. This can reduce joint-motion pain and make push-off more comfortable. It does not restore the lost bend, and the toe may feel different inside shoes. Results depend on the joint damage, toe position, bone quality, smoking status, general health, and whether the fusion heals in the intended alignment.

A fused big toe still needs enough position and length for walking. Footwear, work demands, and activities that require the toe to bend should be discussed before choosing surgery.

Ask the orthopaedic surgeon which joint is involved, how the toe will be positioned, and what protection is needed while the fusion heals. Plan for the recommended boot or stiff-soled shoe, keeping dressings dry, and arranging help with transport and household tasks. Follow the weight-bearing instructions closely; loading the foot too early can disturb alignment. Physiotherapy may focus on gait, ankle movement, and maintaining strength around the foot rather than bending the fused joint.

Contact the surgical team promptly for worsening pain, spreading redness, drainage, fever, a dressing that becomes soaked, new numbness, or toes that turn unusually pale or blue. Urgent assessment is needed for severe calf swelling or pain, sudden chest pain, or breathlessness. If pain remains significant or walking does not progress as expected, arrange a review so the surgeon can check healing and alignment.

What makes fusion more suitable for my joint than a motion-preserving procedure? How will the toe position affect walking and footwear? When can I drive, work, and return to exercise? What signs would suggest delayed healing or a problem with the fixation?