What to expect after orthopedic foot and ankle surgery

Most of the surgery that we perform here at Orthopedic Foot and Ankle Center will require immobilization after surgery. This will depend on the type of surgery. Each category has a different recovery time. Because ligaments take on the average 6 weeks to heal, we need to immobilize the leg to make sure the repair does not spread apart. Suture is often not strong enough to allow full weightbearing right away. Once the ligaments have healed, we allow progressive weightbearing and motion to strengthen the newly scarred repair and to accelerate remodeling of the ligaments and tendons. This is done carefully first with a weighbearing cast and then a removable cast. Finally, we believe physical therapy is important to rehabilitate our patients back to their original strength and balance.

Soft Tissue Procedures

  • Ankle Stabilization
  • Brostrum Repair
  • Evans Procedure
  • Ankle Arthroscopy with Thermal Capsular Shift
  • Ankle Arthroscopy with Repair of Osteochondral Defect
  • Peroneal Tendon Repair
  • Posterior Tibial Tendon Repair with or without a Calcaneal Osteotomy
  • Tendon Transfers
  • Repair Achilles Tendon with or without Partial Excision of Calcaneus
  • Tarsal Tunnel Surgery

Our standard protocol for soft tissue procedures are:

  • Follow up to the office 7 to 10 days after surgery. Keep the postoperative dressing dry. Elevate the leg for comfort. Ice for comfort.
  • 3 weeks in a fiberglass cast nonweightbearing. We do allow you to stand on the cast but no walking is allowed. Crutches or a walker or a wheelchair is needed.
  • 3 weeks in a fiberglass cast weightbearing. Full weightbearing with no assistive devices is allowed. Excercising on a stationary bicycle or a healthrider is allowed. Weight training limited to upper body excercises are allowed as well.
  • 3 weeks in a removable cast or boot walker. This is taken on and off to shower/bathe, sleep, and to drive. Motion is encouraged when the boot is taken off. Remind the nurse to consider a compression stocking if you are having trouble with swelling.
  • 3-6 weeks of Physical Therapy. Careful attention to bring back strength, motion, and flexibility. We have several customized protocols for your rehabilitation. If appropriate for your type of surgery this protocol will be provided to your therapist.

Bone Procedures

  • Ankle Fusions
  • Subtalar Fusions
  • Triple Arthrodesis
  • Pantalar Arthrodesis
  • Midfoot Fusions
  • Any repair of any fractures including:
  • Ankle fractures
  • Talar fractures
  • Calcaneal fractures
  • Lisfranc fractures (tarsometatarsal fractures)
  • Metatarsal fractures

Bone procedures require more immobilization. Bones on the average take 7 weeks to heal to about 80% of their normal strength. Once healed, we progressively stress the bone to accelerate remodeling of the bone and to improve its compression and tensile strength.

Our standard protocol for bone procedures are:

  • Follow up to the office 7 to 10 days after surgery. Keep the postoperative dressing dry. Elevate the leg for comfort. Ice for comfort.
  • 4 weeks in a fiberglass cast nonweightbearing. We do allow you to stand on the cast but no walking is allowed. Crutches or a walker or a wheelchair is needed.
  • 4 weeks in a fiberglass cast weightbearing. Full weightbearing with no assistive devices is allowed. Excercising on a stationary bicycle or a healthrider is allowed. Weight training limited to upper body excercises are allowed as well.
  • 4 weeks in a removable cast or boot walker. This is taken on and off to shower/bathe, sleep, and to drive. Motion is encouraged when the boot is taken off. Remind the nurse to consider a compression stocking if you are having trouble with swelling.
  • 4 weeks of Physical Therapy. Careful attention in Physical Therapy will help bring back strength, motion, and flexibility.

Forefoot Surgery

  • Bunion Surgery
  • Hammertoe Surgery
  • Weil Osteotomy
  • Excision Interdigital Neuroma
  • Excision Ganglion Cyst
  • Cheilectomy
  • 1st Metatarsal Fusion
  • Bunionette Surgery

Forefoot surgery has the advantage that most patients can walk on their heels. Because we find that our patients are careful during the recovery time, we allow our patients to put full weight on their heels immediately after forefoot surgery. A wooden shoe or a postop shoe (the ugly sandal you see many of our patients wearing!) is prescribed. This shoe assists in putting weight on your heals. It also prevents you from bending your foot while walking. It forces you to walk stiff legged and slows down the walking pace. All these factors allow our patients to full weight bear and to protect the surgery while they are recovering.

  • Follow up to the office 7 to 10 days after surgery. Full weight bearing immediately after surgery. Some people may prefer using a crutch or cane for a few days to aid in balance.
  • Removal of postoperative dressing and stitches or staples. Advancement into an Ace bandage dressing. This dressing will be taken on and off several times a day to reset the elastic compression. It also allows the incision to breath.
  • Return 4 to 8 weeks for final Xrays and advancement into comfort shoes. (see our section on Shoes).

Sports Medicine

  • Ankle Arthroscopy
  • Cartilage Transplants
  • Ankle Replacements
  • Laser Surgery

Sports medicine and our advance techniques require specialized recovery plans. These are individualized based on our patients needs and requirements. A thorough recovery plan will be outlined by your doctor and nurse before surgery. The important test before returning to sports or any aggressive activity is balance.

Our athletes must be able to do:

  • Single limb heel rise 20 times.
  • Single limb stand with eyes closed for 20 seconds.

We have found that these two simple tests are excellent indicators of full recovery.