{"text":"Operation Sheet Mr Vats Date: 16\/10\/2018 \n-Mrs Agnes Clelland f Surgeon: ' Arn,if Vats \n\u2018Qperatlbn: Left 1st MTPJ Fusaon ; : K[}a\u00e9gthetisfz_ \"M Mackinnon \n. 1st MTPJ Osteoarthritis Secondary 0 ' \n' Preparation and Position: \nImaging reviewed \nWHO. Checklist \nCefuroxime 1.5g.lV prior to KTS \nGA and ankle block \nT~ raiquet 250mmHg 60mins, elevated prior to inflation \niholic Chlorhex prep and drape \nIncision and Approach : \nStandard dorso-medial approach \nDirect horizontal incision over 2\u2122 toe PIPJ for fusion \nFindings : \nAs expected from radiology \nHallux Rigidus deformity of great toe \nHammering of second toe with evidence of early callus formation \n-| Capsulotomy \nProcedure : \nAs above \nbunionectomy performed \nJomt surface prepared with a burr. Jomt fused with 2 memory staples in correct position with silight dorsiflexion. \n2\" toe PIPJ excised with saw : \n1.6mm double ended K-wire used to fuse joint \nWire held in 2\u2122 metatarsal and cut \n0.9% NaCl \nsure : \n\u00ab~ v Vieryl \n2-0 polysporb, glue, wool, crepe and Barrouk shoe - \nPost Op Instructions : \n1. Home when safe \n2. Barrouk shoe for 6\/52 HWB . \n3. Nurse led foot clinic review 2\/52 for wound review and trimming of suture ends \nRemoval of K-wire 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