Moderate pain is expected after surgery on your lower extremity. A prescription for pain medication has been provided.

• Ice may be used to help control pain and swelling.
   
  • Apply for 30 minutes at a time, several times per day.
     
• Keep your leg elevated above the level of your heart as much as possible for the first two weeks.
   
  • Sleep with your leg elevated when possible.
     

Pain medications do not eliminate all pain (except general anesthesia), but they should make your symptoms tolerable enough to:

• Sleep
   
• Perform simple daily activities
   

Pain medications may cause:

• Itching
   
• Nausea
   

These symptoms are often relieved with diphenhydramine (Benadryl) when used as directed.
You may also have been prescribed an anti-nausea medication such as:

• Ondansetron (Zofran)
   
• Promethazine (Phenergan)
   

• Pain medications can be addictive.
   
• Begin weaning off them as soon as reasonably possible.
   
• Depending on your surgery and pain tolerance, you may need pain medication for a few days or a few weeks.
   

• Beginning the day after surgery, take Aspirin 325 mg (enteric-coated) once daily with food for 30 days.
   
• Do not take Aspirin if you are unable to tolerate it—talk to your physician for alternatives.
   

Please follow these instructions carefully:

• If you were placed in a non-removable splint or cast, do not remove it until your follow-up appointment.
   
• You may have a soft surgical dressing:
   
  • This may be removed 5 days after surgery.
     
  • Keep the incision covered with clean gauze afterward.
     
• Some incisions have adhesive Steri-Strips:
   
  • Leave these in place until they fall off on their own or are removed by your physician.
     

• Ankle brace:
   
  • Must be worn at all times, including while sleeping.
     
• Hard-soled post-operative shoe:
   
  • Must be worn at all times, including while sleeping.

• Postoperative Splint
  • Remains in place until follow up
     

• Elastic wraps may be loosened if they feel too tight.
   
• Wear elastic wraps to help control swelling.
   
• Some blood-tinged drainage is common for the first 1–2 days.
   
• If your dressing becomes wet:
   
  • Add clean, sterile gauze as needed.
     
• Call your physician if drainage continues beyond 2–3 days.
   

Bruising near the surgical site is common and will resolve on its own.

• Go home immediately after surgery.
   
• Limit activity and elevate your leg.
   
• Move your toes, ankle, and knee frequently (as your dressing allows) to help prevent stiffness.
   

Your specific weight-bearing status will be determined by your surgeon. Common instructions include:

• Non–weight bearing until ____________ or ____________ weeks
   
• Partial weight bearing: ____________ % until ____________ or ____________ weeks
   
• Weight bearing as tolerated (full foot)
   
• Weight bearing as tolerated (heel only)
   

• If allowed to bear weight:
   
  • You may stop using crutches once you can walk without significant pain, limp, or balance issues.
     
• If not allowed to bear weight:
   
  • Use crutches, walker, knee scooter, or iWALK device as needed.
     

• You may shower, but keep your dressing dry using a sealed bag.
   
• If your dressing has been removed:
   
  • You may gently wash your leg in the shower.
     
  • Clean around Steri-Strips or stitches and pat dry.
     
• Do not apply ointments to the incision.
   
• Do not swim, use a hot tub, or submerge your leg until the incision is fully healed
  (minimum of 3–4 weeks).
   

• If you do not have a follow-up appointment scheduled within 1–2 weeks, please call the office.
   
• If you were given surgical photos at discharge, bring them to your first postoperative visit.
   

• Fever over 101°F
   
• Increasing redness around the incision
   
• Calf pain, tenderness, or cramping
   
• Excessive bleeding or drainage
   
• Severe or worsening pain
   

(To be provided by your surgeon if applicable)

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 

We are committed to providing patient-centered care. We take the time to listen to your concerns, answer your questions, and work with you to create a treatment plan that meets your unique needs.