Immediately after surgery:
- Dressings: Following surgery, a bandage with a plaster splint is applied to the ankle until the stitches are removed in 10-14 days at your follow-up visit. Keep the splint clean and dry. You may shower or bathe, but must keep the splint covered with a bag to prevent it from getting wet.
- Bleeding: It is not uncommon to have some oozing from the incisions under the splint with some mild bloody drainage through the bandage.
- Swelling: Swelling is expected and elevation of the extremity is the most important thing to do to decrease the swelling. Swelling can cause you to have some numbness in the foot initially. Try to elevate the leg above the level of the heart for the first 1-2 weeks. It is ok to be up some but plan to make elevation a priority
- Relief of Pain: Please refer to the separate pain management handout that you will be given on the day of your surgery
- After Anesthesia: Nausea and vomiting can occur, although unusual. If you have a tendency for this, please discuss this with the anesthesiologist. This can usually be alleviated with a clear liquid diet, slowly advancing to a bland and then regular nutritious diet as you feel better. Drowsiness can also persist for 48 hours after anesthesia. Slight fever is also normal post operatively, but you should notify your surgeon if you have a temperature greater than 101.5 degrees.
- Activities: Assistive devices such as crutches, rolling knee walker, or walker will be needed after surgery. No walking or putting weight on the foot is permitted until 2 weeks after surgery or when cleared by your surgical team.
- Driving: You cannot drive while taking narcotic pain medication. If the left ankle is repaired, you may be able to drive an automatic transmission vehicle by 1-2 weeks (or when prescription pain medications are discontinued). If it is the right ankle that is repaired, usually around 6-10 weeks after surgery when you are putting your full weight on your ankle.
Two weeks after surgery:
- Suture Removal: You will follow-up with the surgeon or physician assistant at approximately 10-14 days after surgery for suture removal and dressing removal.
- Showering after suture removal: Showers are acceptable 24 hours after the splint and sutures are removed. Your sutures are usually removed at your first post-operative appointment. Once the sutures are removed in the clinic we will place steri-strip bandages over the incision. Leave these on until they peel off on their own. Do not soak the ankle in a tub or submerge it. You need to keep your incisions as dry as possible. After showering, make sure that you carefully pat dry the ankle area.
- Removable Boot: A removable boot will be applied at the 10-14 day visit. Wear this during the day when out of bed and when sleeping in bed. You can shower without covering, pat incision dry, no submerging incision area.
- Physical Therapy/Activities: At 2 weeks, you will start a progressive weightbearing program where you start by putting a small amount of weight on your leg in the walking boot and advance the amount of weight every week. Physical therapy will start at this point, and the therapist will guide you with how much weight you can apply, and what exercises to do. Any time you are putting weight on your leg, it should be in the walking boot. You will require crutches until you are able to put your full weight on your leg, which is generally until 6-8 weeks after surgery. Once you are putting your full weight on your leg, you will start to transition out of the boot.
- At 2 weeks, start ankle motion out of the boot 3 times each day as instructed. At this point, you should only move your ankle up and down, no in and out or side to side motion. At the 6 week mark, your physical therapist will start in/out and side to side motion.
- Signs of Infection: With any surgery it is important to be aware of signs of infection, which include: increased redness or odor, drainage from incision, and increased fever (above 101.5 degrees); you should contact our office if any of these signs are noted.
Eight to twelve weeks after surgery:
- Swelling: Ankle swelling will generally persist for about 6-12 months.
- Physical Therapy/Activities: At this point, you are usually putting your full weight on your leg without crutches and you are starting to wean out of the boot and back into regular shoewear. You will continue with physical therapy working on resuming normal activities with a goal of restoring motion, strength, balance and working toward walking without a limp. Higher level activities such as walking longer distances or on uneven ground, light jogging, or sports do not typically start until 4-6 months.
- Footwear: You will transition to wearing a regular shoe. We recommend avoiding sandals, flip flops, or high heeled shoes until your strength and balance are restored.
Return to work guidelines:
- You are NOT allowed to drive with the cast boot or cast.
- Desk job: We recommend taking 2 weeks off to rest with your foot elevated. Once you do return, we recommend that you are off of narcotic pain medications, have a way to get to work, and you can sit with your leg elevated while at work.
- Light duty: If your work requires you to be on your feet, you may be allowed to return to work around 6-8 weeks after surgery. This will be with limitations in the number of hours you are allowed to stand and the amount of weight you can carry. It takes a minimum of 6 weeks before you are putting your full weight on your leg.
- Heavy labor: Expect to be off of work for up to 4 months. If light duty work is available, then refer to above restrictions.
Call the office for:
- Pain not controlled by pain medications, rest, and elevation.
- Temperature >100.5 or chills.
- Contact us at: (503) 659-1769
