Immediately after surgery:
- Dressings: Following surgery, a compressive is applied to the ankle until the stitches are removed in 10-14 days at your follow-up visit. The dressings should not be removed until your follow-up. Keep the dressing clean and dry. You may shower or bathe, but must keep the dressing covered with a bag to prevent it from getting wet.
- Bleeding: It is not uncommon to have some oozing from the incisions under the dressing 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 at or slightly 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: You are allowed to put weight on your foot but only in the post-op shoe provided to you. Whenever you put weight on the foot, it should be in the shoe. You do not need to sleep with the shoe on.
- Driving: You cannot drive while taking narcotic pain medication. If the left foot 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 foot that is repaired, you can usually start driving around 3 weeks after surgery.
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 dressing and sutures are removed. Your sutures are usually removed at your first post-operative appointment. Once the sutures are removed in clinic we will place steri-strip bandages over the incision. Leave these on until they peel off on their own. Do not soak the foot 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 foot.
- Shoewear: If cleared by your surgical team, at this point you can start transitioning to regular shoewear. It is recommended that you use shoes with good cushioning, stiffer soles, and wide toe boxes.
- Activity: At 2 weeks, you will start becoming more comfortable walking and standing for longer periods of time. At this point you can slowly start to increase the amount of walking you are doing. Start increasing the distances you are walking on level ground letting pain be the guide.
- At 2 weeks, begin doing range of motion exercises of the toe. Use your hand to move the toe up (dorsiflexion) and down (plantarflexion). I recommend doing 30 repetitions of dorsiflexion and plantarflexion at least 3 times a day. At the end of 30 repetitions, hold the toe in as much dorsiflexion as you can tolerate for 2 minutes.
- 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.
Six to twelve weeks after surgery:
- Swelling: Foot swelling will generally persist for about 3-6 months, so it is normal for the foot and toes to still be swollen
- Activities: At this point, you may still have some soreness to the joint but you can start advancing activities as tolerated. It is recommended that you continue to use shoes with good cushioning, stiffer soles, and wide toe boxes. Continue advancing your distances and slowly build in inclines, declines, and uneven ground letting pain be the guide. Slowly reintroduce impact activities such as light jogging. As you get more comfortable you can slowly start reintroducing running and jumping. Return to sports is generally around 3 months.
- Footwear: It is recommended that you use shoes with good cushioning, stiffer soles, and wide toe boxes. We recommend avoiding sandals, flip flops, or high heeled shoes until your strength and balance are restored.
Return to work guidelines:
- Desk job: We recommend taking at least 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 can sit with your leg elevated while at work.
- Light duty: If your work requires you to be on your feet constantly, you may be allowed to return to work around 4-6 weeks after surgery. This may be with limitations in the number of hours you are allowed to stand and the amount of weight you can carry.
- Heavy labor: Expect to be off of work for up to 6-8 weeks. 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
