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To make your foot or ankle surgery recovery as seamless as possible, it’s important to take a proactive approach to recovery. This article contains important information about your surgery and post-operative care. We wish that your post-operative recovery be as quick and comfortable as possible. If you have any questions please do not hesitate to call our office at 415-927-5300.
Anesthesia
If you had general anesthesia you may experience nausea, fatigue, or mild confusion for the next 24-48 hours. Please do not worry and try to relax at home as this will wear off with time. We often use a popliteal nerve block, which will make your leg numb and you will not be able to move your foot, ankle or lower leg, this can last anywhere from 24-72 hours, please note that this is temporary and your sensation and movement will come back. After your surgery start drinking clear liquids and eating light foods, if you tolerate this well then you can advance your diet to more solid foods.
Medication
Start taking your pain medication on your first night at home. We recommend scheduling 1 pain pill every 4-6 hours for the first 3 days then you can take the medication as needed. This helps ensure that as the nerve block wears off the transition will be smooth and will keep you “ahead” of the pain when the block wears off. We commonly prescribe ibuprofen 400 mg three times a day for the first three days, please take this as written as it will assist in your postoperative pain control. Keep taking the stool softeners concurrently with the pain medication since it is not uncommon to experience constipation with pain medication. We prescribe aspirin lovenox, coumadin or xarelto for DVT prophylaxis, please start this on your first night at home and follow the dosing instructions carefully. If you experience any adverse reactions such as rash, upset stomach, trouble breathing, or confusion, stop your medication and call our office at 415-927-5300.
Activity
Unless instructed otherwise, you should remain non-weight bearing on the operated leg and use your crutches, walker, &/or knee scooter. When you are resting it is advisable to keep your leg elevated at or just above the level of your heart to minimize swelling, pain and potential wound problems. Elevation will be key to decreasing discomfort and swelling. Try to avoid strenuous activities such as stair climbing or prolonged walking/standing. Once the nerve block wears off try to curl all of your toes as if you were trying to pick up marbles and then relax your toes, do this about 15 times every hour. Begin tightening your thigh muscles and start practicing elevating your leg, with the splint your leg will be heavy and might need a family member to assist you in the beginning. Start the leg raises around 5 days after your surgery, try to do approximately 15 raises every hour. These exercises will minimize deconditioning and help protect against developing blood clots.
Wound Care
Your splint and bandage should remain on until your first visit after your surgery. Please avoid getting it wet or dirty, which can increase your chance of infection. You may shower provided you can adequately cover and protect the leg from dampness and you can safely keep weight off your leg during the shower. Medical supply stores often sell “cast bags” but you can also use an industrial garbage bag with duct tape. Please do not immerse your foot/ankle in water such as taking a bath. Occasionally, there will be some staining that could occur on the outside of the splint or dressing, this is usually self limited and of no concern, however, if the staining continues to expand 1 Paul Kim, MD Board Certified Orthopedic Surgeon www.drpaulkim.org then please call our office at 415-927-5300. If you feel your splint &/or bandage has become too tight, the most common cause is over activity or lack of elevation, a short period of elevation, ice and rest usually relieves the pressure sensation but if it continues to be a problem please call our office at 415-927-5300. Please do not remove the splint or bandage unless we instruct you to do so.
Diet and Bathroom
On the evening after your surgery start with liquids and light food (jello, clear soup) and then advance your diet as tolerated. Some people will experience nausea and constipation after surgery, this is usually caused by the pain medication and will subside with gentle upright activity and decreasing your use of the pain medication. As mentioned, as long as you are taking your pain medication continue taking your stool softeners.
Problems
Call our office at 415-927-5300 if you experience any of the following: persistently elevated fever or chills, increasing swelling and pain that does not resolve with elevation, trouble urinating, increased redness with red streaks coming up your leg, any visible pus or foul odor drainage, any perceived significant change in the position of any pins, disproportionate pain not controlled with the pain medication, expanding drainage or a soaked dressing, or any worrisome condition. If an emergency arises and you cannot call the office please go to Marin General hospital and ask to be seen by the on-call orthopedic physician.
Follow-up
An appointment for follow-up is usually 10-14 days after your procedure. Make sure you verify the date and time with our office. At the time of follow-up your leg will be examined and the sutures will be removed. Depending on your surgery you will either be placed into a removable boot, hard soled shoe or a short leg cast. Therapy usually starts around 6 weeks after surgery but may vary depending on your surgery.
