PIG Meeting: 8th April 2021

78-year-old lady for amputation of 4 toes due to valgus deformity

Background

• Long-standing valgus deformity of toes, limiting ability to wear shoes
• Wheelchair-bound following complex ankle surgery on other foot
• Hiatus hernia with significant symptoms including daily nausea and vomiting, waterbrash and a hoarse voice

Issues

• Hiatus hernia repair scheduled for 4 weeks after foot surgery
• Patient very keen to proceed with both procedures as scheduled

Discussion

• Likely safer to defer foot surgery until after hernia repair
• Patient is aware of risks and if wants to proceed then that is reasonable
• Neuraxial anaesthesia is an option

Plan

• Discuss with general surgeon as they may not feel that timing of the foot surgery gives adequate recovery time before hernia repair