Before anyone proceeds with a surgery of any kind, they want to know what will the recovery look like? When can I walk, how often do I ice, how often do I elevate, what pain medications should I take…etc. This blog serves as a general guide, but know that the day of your pre-operative appointment with Foot and Ankle Associates of North Texas (FAANT), we will provide you with a week by week recovery guide for you to follow. Each surgeon may adjust these instructions based on your specific surgery, medical history, and quality of your bone. Please discuss with your surgeon any questions that you have the day of your appointment, and after surgery make sure to call with any questions or concerns tha arise.
Day of Surgery
Head home in your walking boot, bearing weight on your heel or flat footed with the assistance of of walker or crutches in in the home. Think the brides maid walk for a visual. When outside of the home make sure to use a knee scooter for long distance travel, which can be purchased online, or rented from a local vendor. Walking will be to go to restroom, or kitchen to quickly get a bite to eat, otherwise you will be resting on the couch or bed or recliner with surgical foot elevated. When resting, the boot can be removed, but if sleeping it is recommended to wear for protection from weight of bedsheets, and when walking or using a knee scooter use is a must.
Ice the foot directly to operative or to the ankle if dressing does not allow cold to penetrate. I recommend on for 30 minutes, off for 30 minutes the first day while awake, don’t wake up through the night to ice - you or your loved one who gets the ice might go a little crazy! This can be reduced to 4 times a day after day one.
Wiggle you toe twice daily gently for several minutes, to prevent scar tissue adhesions from stiffening the great toe joint. Your toe will not move dramatically but every little bit helps.
Leave the surgical bandage intact, and take your pain medication as prescribed by your physician. When bathing use the supplied cast protector, but bathing the first three days is not all that important since your activity will be reduced and hanging leg down to bath while seated in shower can cause increased swelling and pain.
Post-Operative Day 1 to First Post-Op Appointment
The rules stay the same, you can just ice a little less frequently, 3 to 5 times a day. Usually all anesthetic medication administerd in the operating room will have been metabolized, and you will be able to gauge your pain. If pain is minimal it is not recommended you cease narcotic medication just yet, but instead you could lengthen time between doses.
First Post-Operative Appointment (3-7 days after surgery) until 2 weeks
This appointment you will have x-rays taken, the physician will change your dressing, and discuss any concerns you may have. Until your two week follow-up appoitnment, instructions will remain the same, except you can more effectively ice your foot right to operative site because replacement bandage will be much thinner, icing 4 times a day is recommended.
Second Post-Op Appointment (2 weeks) until 6 weeks Post-Op
If you have sutures to remove, they will be removed at two weeks, if a cosmetic closure was selected no sutures will need be removed this day. Your dressing will be removed and replaced with a nylon ankle sleeve, that when placed on foot first thing in morning, will prevent excessive swelling and help reduce pain and improve healing. Icing will continue at least once daily, and a pad called a toe spreader may be prescribed to keep you operative toe nice and straight during recovery.
To produce a beautiful incision result, scar cream or gel sheets will be recommended for daily application.
To prevent stiffness physical therapy will be prescribed as well as home exercises. Therapy is typically 2-3 times a week for 4-6 weeks. Not all patients need therapy, but at least an evaluation is reocmmended.
Two weeks after surgery walking is still recommended to be limited and in your boot, but as each week progresses, more and more pressure can be applied to tolerance. By four weeks after surgery use of crutches is usually discontinued completely, as an assistant to weightbearing.
If you need to drive and your surgery was to the right foot, a post-operative flat soled shoe may be provided. Note, this is only to be used for driving, and for short distances only. Your provider may not allow this due to your specific circumstances or other procedures may have had done to your foot on the day of your lapiplasty.
6 Weeks to 12 Weeks after Surgery
At your 6 week appointment a X-ray will be taken to confirm healing and you will be transitioned into an athletic shoe with an insert to support the arch as it heals. A half size larger shoe may be required temporarily due to swelling. Continued icing, scar cream application, range of motion of great toe, and nylon ankle support is recommended.
12 Weeks and Beyond
At 12 weeks an X-ray will be taken and instruction on return to impact exercises will be given. Exercise will be allowed throughout the recovery but only non-weightbearing exercise will be allowed early on. Often stationary biking, casual walking, and rowing will be allowed before 12 weeks at physician’s discretion. As you slowly return to impact exercise this will be a slow process, and full activity will return at 4 months(16 weeks) after surgery.
Full recovery will be 6 months to a year. This does not mean that you will laid up the whole time or will have to drag your leg behind you like Igor, it only means that you will have occasional discomfort, swelling, and pain based on activity level.
Remember, everyone’s recovery differs, and each physician may cater a plan to your recovery based on your health, severity of deformity, overall medical health, and how you are recovering. These instruction serve merely as a preliminary guide of expectations, please discuss any exercise or activity with your physician before you proceed.