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MEDICATIONS
Moderate pain is expected after surgery on your lower extremity. A prescription for pain medication has been provided. Ice
may also control the pain and swelling and can be used for 30 minutes at a time, several times a day. Keep leg elevated above the
level of your heart as much as possible the first two weeks. Sleep with your leg elevated above the level of your heart. No pain
medicine relieves all pain (except general anesthesia), but the pain medicine should make your symptoms tolerable enough to
sleep and carry out simple activities of daily living.
Pain medicine can cause itching and nausea. These symptoms are often relieved with diphenhydramine (eg Benadryl), when
used as directed on packaging insert. You may have also been prescribed an anti-nausea medication, like ondansetron (Zofran)
or promethazine (Phenergan) which will help with these symptoms.
Remember pain medicines are addictive and you should try to wean yourself off them as soon as reasonably possible. Depend-
ing on your particular surgery and pain tolerance, you may be using pain medicines for a few days or a few weeks.
Beginning the day after surgery, take a 325 mg enteric-coated Aspirin once daily with food for 30 days to help prevent blood
clots. Talk to your doctor if you can’t take Aspirin.
DRESSINGS AND MEDICAL DEVICES
• You have been placed into a non-removable splint or cast, please leave this in place until your follow-up appointment.
• You have a soft surgical dressing which you may remove 5 days after surgery. Keep your incision covered with clean
gauze afterward. Some incisions may have adhesive steri-strips on the skin. These must be left in place until you see your
physician or until they fall off on their own.
• You have an ankle brace. You must wear it at all times, even in bed.
• You have a hard soled post-op shoe. You must wear it at all times, even in bed.
If your elastic wrap feels too tight you may wrap it more loosely. Wear the elastic wrap to control swelling. It is common to have fluid drainage for the first couple of days, which may be blood tinged. If your dressing becomes wet on the outside from incision leakage, add to the dressing using sterile gauze sponges which were sent home with you or can be found at most stores. If drainage persists for more than two to three days you should call your physician. You may develop bruising near the surgical site. This is normal and will resolve on its own.
EXERCISES AND ACTIVITIES
Immediately after surgery you should return home, limit your activity, and elevate your leg. Move your toes, ankle and knee
frequently, as your dressing allows, to help prevent stiffness.
WEIGHT ON YOUR OPERATIVE LIMB: (some common scenarios for postoperative wb)
• Non-weightbearing until ____________ or _________ weeks
• Partial weightbearing: ____________ % weightbearing until __________ or _________ weeks
• Weight as tolerated, full foot
• Weight as tolerated, heel only
If you are allowed to put weight on your limb, when you are able to walk with little pain and without a significant limp or
balance trouble you may discontinue crutches. If you are not allowed to put weight on your limb, you may need to use crutches,
walker, knee scooter or iWALK device to help with ambulation.
BATHING
You may shower but keep your dressing dry with a sealed bag. If you have been allowed to remove your dressing before your
follow-up appointment, you may begin to wash your lower extremity and shower after the dressing comes off. Wash around the steri-strips or stitches and pat them dry. Do not apply oinments to incision. Do not swim, use a hot tub, or completely sub-merge your lower extremity until the incision is completely healed (a minimum of 3-4 weeks).
FOLLOW-UP
If you do not have a follow-up appointment within 1-2 weeks after surgery please call the office to schedule one. If you are given
photos at discharge, please bring them to your first post-operative appointment. If you develop a fever over 101°, redness, calf
tenderness/cramping or pain, more than a small amount of bleeding or drainage, or severe pain please contact our office.
ADDITIONAL INSTRUCTIONS
BIKING/SWIMMING: may begin at 8 weeks post-op
RUNNING/HIGH IMPACT: may begin 4-6 months after surgery
FULL ACTIVITY: return to sports may begin when you can come up and down on your toes (single heel rise) or hop (single leg hop) on the surgical side. This may take 6 months to a year.
PHYSICAL THERAPY: start between 4-6 weeks post op, focus on motion and swelling at first, then gait training and strengthening
focus on hip/knee/core for first 6-10 weeks
patient specific desires on gait training with/without therapist
DRIVING: Prior to driving, you must be able weight–bear on your right foot without crutches. In addition, you may begin driving at 9 weeks if surgery on right ankle; if left ankle, may drive automatic transmission car when off narcotic pain medication
FULL ACTIVITY: This may take 6 to 18 months. There is no guarantee on outcome. All conservative management options have risk of worsening pain, progressive irreversible deformity, and failing to provide substantial pain relief. All surgical management options have risk of infection, skin or bone healing issues, and/or worsening pain. Our promise is that we will not stop working with you until we maximize your return to function, gainful work, and minimize pain.
SHOWERING: You may shower with soap and water 1 day after surgery. Avoid lotions, creams, or antibiotic ointments on surgical site until directed by your orthopaedic surgeon. No baths or submerging operative site under water until incision has completely healed.
SKIN CARE: Steristrips are typically placed on your incision at your follow up appointment. Steristrips will typically fall off on their own. Remove steristrips in shower after 3 weeks if they remain on incision. Incisions may become sensitive. Some surgical incisions based on their location and patient factors are more likely to require postoperative scar desensitization with physical therapy. You may use Mederma or other skin protectant lotion once incisions have completely healed and approved by your orthopaedic surgeon. Do not placed cortisone or other steroid on your incision unless directed by your orthopaedic surgeon. Incisions and surgical site scars are more prone to burn by ultraviolet radiation when out in the sun. Always apply sun screen onto the healed incision once fully healed.
STOOL SOFTENERS: While on narcotic pain medication (e.g. Norco/hydrocodone or Percocet/oxycodone) especially within first 72 hours of surgery, you should take stool softener (e.g. Miralax, docusate, senna). Discontinue if you develop loose stool or diarrhea. The