Name:
Chilectomy Of Big Toe
Description:
Chilectomy Of Big Toe
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/3c159459-92ba-4fe7-a7ae-cf740e78b167/videoscrubberimages/Scrubber_1.jpg
Duration:
T00H05M00S
Embed URL:
https://stream.cadmore.media/player/3c159459-92ba-4fe7-a7ae-cf740e78b167
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/3c159459-92ba-4fe7-a7ae-cf740e78b167/Chilectomy of Big Toe.mp4?sv=2019-02-02&sr=c&sig=jq3oh5vjP%2B4CZijZZ5opLSU3SNfuwp72k3075fj58r8%3D&st=2024-11-23T09%3A40%3A33Z&se=2024-11-23T11%3A45%3A33Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello, with us today, I'm going to take you through a surgery which is called chilectomy of the great toe. It is an extremely common operations, both in Caucasian population and in Asian population, in patients who have got arthritis of the big toe. Now, if you are coming to my channel for the first time, I would advise you to kindly subscribe it as there are many useful videos which will be useful in your clinical practice.
So my aim today is to show you how to do chilectomy properly in a step by step manner. So this is our table position. Patient is supine. We are going to use tourniquet because it is going to make my surgery bloodless and I am able to see things better. When I'm operating on the toe, I prefer a patient to be the foot to be slightly off the table.
So it's the foot is slightly at the edge because I operate from here, so I will be sitting here. So this gives me good access. I don't have to stoop forward when I'm operating on the great toe. Now my trolley will be on the left hand side. Now Cushwan will take my place and will assist from this place. So the next step will be to show you the visible deformity range of motion of the big toe and show you the skin marking.
So if you see the X-ray of this lady, you can see on an AP view there is a loss of joint space and there are formation of osteo fights medially as well as laterally. And if I show you the lateral, you can see this area here. This spike is usually responsible for a lot of pain and disability. So we are going to remove this lesion. This is just a zoom picture of that apology for not showing you the great X-ray because our park system is down.
But this gives you an idea about the extent of lesion both on AP and lateral view. If you look at so if you look at the big toe, you can see this bump here. Can you see this bump? This is the dorsal ossified that you were seeing on the plane X-ray. Now, whenever you are operating on the toe, you will see that this is the dorsal skin, which is slightly dark colored and this is the skin of the sole.
So your incision should be at the junction of both. So this is my skin incision and this is I've just drawn some vertical lines. It helps me approximating it when I'm closing it. So start with the skin incision. I'll try my best that my hand is not in your way and you are able to see what you need to see. So just go straight, make the skin incision, and then try to raise the flap both front.
And whenever you're operating in foot and ankle or a lower limb, as I say in most of my videos, don't pinch the skin, just raise the skin. So I'm just going to raise the flap on both the sides. And once I have raised the flap, I will join you back. So just raise the flaps slightly so that myself Vinay can go in and you see the self retainer. This is not a tooth one. This is blunt so it doesn't damage the skin.
So try to use if at all. If you are using a self-retainer, try to use a blunt one and then continue raising the flap. Now when you raise the flap, occasionally you can encounter some superficial nerves. So try to protect them. Stay close to the capsule and just keep on reflecting. So once I have reflected a bit more, I will come and join you. So whenever you are operating here, you will always find a superficial nerve.
So this is the superficial nerve which will supply the sensation to the toes. So the only useful thing during the surgery is to protect this nerve and keep it to the side so that you don't damage it. Otherwise, it can lead to painful neuroma and also unnecessary numbness of the toes. So always, always protect this nerve. So I will ask Whishun to take a cat spore and protect this nerve on the other side.
So this is out of the way so that I am now safe and then I can keep on working to raise the flap. So once you have raised the flap, you have protected the nerve. This white thing that you see is the capsule of the first metacarpal phalangeal joint. So this is the capsule.
So your next step will be to just stay in the midline and go straight on to the bone. There's nothing, there's nothing to worry about. Just stay close to the bone and in size. The capsules that do the capsule are.
Form Title Download
Form Title Bookmark
Form Title Share
Form Title Cite
