Tenotomy of the toes
What is tenotomy of the toes and why does my child/young person need this
operation?
Tenotomy of the toes is an operation to straighten curly toes.
What are the benefits of my child/young person having this operation?
The benefits are that:
The posture of the toes will be improved.
The chance of developing hard thickened skin around the toe joints (callus) will be reduced.
The continued discomfort from footwear will be reduced.
What are the risks, consequences and alternatives associated with my
child/young person undertaking this procedure?
Most operations are straightforward; however as with any surgical procedure, there is a small
chance of side-effects or complications such as:
Infection.
Failure to correct the deformity.
Stiffness of the affected toe.
If you are concerned about any of these risks, or have any further queries, please speak to your
child’s/young person’s consultant.
The alternative to surgery is to leave the toes to develop in the curled position. This may result in
the development of hard skin, which may be uncomfortable. Strapping has been used, but has not
been shown to improve the deformity significantly.
Getting ready for the operation
You will be informed of your child’s/young person’s pre-assessment appointment and your
child’s/young person’s date of surgery (usually 2 - 3 weeks before the date of admission).
It is necessary to attend a pre-assessment appointment (which is usually a week before the date
of admission).
This visit is necessary to ensure that your child/young person is prepared for theatre. Here you
will be given information regarding the operation and admission. You will also have the
opportunity to ask any questions, whilst familiarising yourself and your child/young person with
the hospital. Verbal and written fasting instructions will be given to you.
You will be asked to sign a form giving consent to your child’s/young person’s surgery at the
outpatient/pre-assessment appointment, or on the day of the operation. At this time, the
surgeon will give you opportunity to ask any further questions.
If your child/young person feels unwell a few days before the operation, please telephone the
Sunflower Ward (details are at the end of this information sheet).
What sort of anaesthetic will my child/young person be given?
When your child/young person comes in for their operation, a consultant anaesthetist (who is a
qualified medical doctor with specific specialist training in anaesthesia) will give the anaesthetic.
The anaesthetist will review the general health of your child/young person and discuss with you
and your child/young person the anaesthetic care plan. If your child/young person has any
specific problems, please inform the anaesthetist at this stage. If you have any questions or
concerns, please raise them with the anaesthetist.
Your child/young person will be given a local anaesthetic cream on the back of their hands in
order to reduce much of the discomfort caused by the anaesthetic injection. Sometimes your
child/young person may be sent off to sleep by encouraging him/her to breathe a mixture of
gases instead of an injection. It usually takes a little longer, but the breathing method is just as
safe and very useful, particularly if your child/young person is very agitated about injections.
You are always welcome to accompany your child/young person into the anaesthetic room
while he/she is going off to sleep.
What to expect after the operation
Your child’s/young person’s toes will have a strapping dressing covered with a bandage. This
will help to keep the toes in position whilst they are healing. This dressing must stay in place
until your child’s/young person’s outpatient appointment.
This operation is performed as a day case which means there will be no overnight stay.
DISCHARGE INFORMATION AND AT HOME ADVICE
The following information is a guide to help in the care of your child/young person after their
operation.
Mobilising
If your child/young person experiences any pain or soreness, intermittently rest the foot/feet
strictly above hip height. Please follow the instructions at the end of this advice sheet regarding
treating your child’s/young person’s pain.
Initially, walking normally may be painful; therefore walking on the heels of the feet may be
more comfortable for a short while. However, please try to encourage your child/young person
to walk normally as soon as they are comfortable.
Footwear needs to be comfortable and not too tight. Adapting old shoes or bigger
shoes/slippers may be necessary, providing they are safe to walk in.
Outpatient appointment
An outpatient appointment will be arranged for 2 weeks after your child’s/young person’s
operation.
Time off school and returning to normal activities
You are advised to keep your child/young person off school until they are safe to walk around
and free from pain, or until their outpatient appointment.
Treating your child’s/young person’s pain after the operation
After the operation your child/young person may be sore for several days. If your child’s/young
person’s behaviour is out of character, this may be due to pain, e.g. he/she cries a lot, is very
clingy, unusually quiet or refuses to eat.
If you think your child/young person is in pain, please give painkillers as directed.
Please be reassured that you will not overdose them if you follow the instructions on the bottle,
nor will they become addicted to the medicines. It is best to give the painkillers regularly for the
first 2 - 3 days after the operation and then as needed.
● Paracetamol (Calpol, Disprol)
This can be given to your child/young person regularly 4 times a day for the first 2 days
after going home, and thereafter as needed up to 4 times a day. Give amount as directed
on the bottle.
● Ibuprofen (Junior Nurofen)
Give this to your child/young person as needed up to 3 times a day. It is safe to give both
Ibuprofen and Paracetamol together, or alternate Ibuprofen with regular doses of
Paracetamol.
● If your child/young person is asthmatic, it may still be safe to give them Ibuprofen as
they may have already had it whilst in hospital. If you are worried about this, please talk
to the nursing staff or doctors before you leave. If your child’s/young person’s asthma
gets worse at home, stop using Ibuprofen, but continue with the Paracetamol as
prescribed. Rarely, Ibuprofen can cause indigestion; if this occurs, stop using it but
continue with Paracetamol.
If you do not understand the advice provided, please speak to a member of the nursing staff or
doctors. If your child/young person suffers a lot of pain at home that does not get better with
these painkillers, please call Sunflower Ward or your GP.
Please ensure that you have these painkillers at home
ready for your child’s/young person’s discharge.
If you have any queries or require further information, please telephone
the Sunflower Ward on 01332 786856
Call 111 for non-emergency confidential health care advice and information, 24 hours a day.
“Call 111 when it’s less urgent than 999”
Reference Code: P0271/0209/11.2009/VERSION3
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of the Trust, nor does their inclusion constitute a recommendation (G12136/03.2005/V2)