info@footandankleunit.co.za | +27 11 647 3735 | +27 11 485 1974 | +27 11 647 3435

POST SURGERY RECOVERY

GENERAL PRINCIPLES AFTER
FOOT AND ANKLE SURGERY

Select a principle below for more information

Protection and Immobilisation

IMMOBILISATION DEVICE: Use the prescribed boot, splint (half cast), cast, or offloading shoe exactly as directed.

WEIGHT-BEARING STATUS:

Non-weight-bearing (NWB): Keep the foot completely off the ground, using crutches or a knee scooter.
Touch-down or partial weight-bearing (PWB): Light toe touch only, progressing as tolerated per surgeon’s orders.
Weight-bearing as tolerated (WBAT): Gradually increase load, using the boot or brace for support.

Make sure you are comfortable with the crutches/walker/scooter before leaving the hospital.

Do not put anything down the inside of the cast to scratch, this may cause a wound and become a source of infection
Do not let the cast get wet

Wound and Incision Care

Keep dry and clean: Protect the dressing/boot from getting wet.
Dressing changes: These will be changed by the surgeon at your follow-up.
Monitor for infection: Watch for increased redness, warmth, swelling, drainage, or fever.
Report any concerns immediately.
If you have wires, do not fiddle with them. Ensure they do not get caught on items like blankets, bed sheets etc.

Swelling Control

Swelling is the enemy.
Elevation: Keep the foot elevated above heart level for >90% of the day until the surgeon gives the go-ahead to reduce this.
Ice therapy: This can be used if there has been no cast applied. Do not apply directly to the skin or to wound dressings.

Pain Management

MEDICATIONS:

You will be given a combination of medications upon your discharge. Please take these as directed. Pain must be prevented and not only treated when it begins. Start using your pain medication as soon as you feel the nerve block wearing off.

SWELLING MANAGEMENT:

This will significantly help the pain. For every hour your leg is down, you will require 23 hours of elevation to prevent swelling.

Deep Vein Thrombosis (DVT) Prophylaxis

Medications: Use prescribed anticoagulants (e.g., direct oral anticoagulants DOAC’s), if indicated by your surgeon.
Hydration: Maintain good fluid intake to reduce clot risk.
Severe calf pain needs to be reported to your surgeon immediately.

Physiotherapy and Rehabilitation

You will be seen by an in-hospital physiotherapist post-operatively.
During your follow-up consultation, you will be given clear instructions to give to your physiotherapist when suitable.
Your physiotherapist will refer you to a biokineticist if and when needed.

Footwear and Orthotic Support

Certain procedures will require specific post-operative footwear, or Orthotics. This will be directed to you by your surgeon and instructions on their use will be given to you.

Follow-Up and Monitoring

Each procedure is different.

FOLLOW UP VISITS:

Typically at 1 or 2 weeks (Wound check).
2 – 4 weeks (Wound check, removal of non-absorbable sutures, conversion to full cast if needed).
6 – 8 weeks (imaging, removal of cast if suitable, X-Rays if warranted and weight-bearing status).
3 – 4 months to remove cast if appropriate, X-Rays if suitable, assess function and address any concerns.

Driving

This will depend on multiple variables.
As a rule of thumb, you will only be allowed to drive once you are fully weight-bearing and out of the cast.
Only drive when you are comfortable, and you genuinely feel safe for yourself and others on the road.
If you are driving an automatic car and your procedure was on your left foot, you will likely be able to drive earlier.
You must be comfortable that you can react quickly in an emergency.

GENERALLY YOU ARE SAFE TO DRIVE WHEN:

You are not taking opiate containing pain killers.
You are not in a cast and wounds have healed.
You have begun physiotherapy and your physio is happy for you to start driving.