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Ankle Surgery - What to Expect?

Before Surgery

Please remove nail varnish and avoid moisturising creams. Likewise, if you have any active infections, please tell us, as your surgery may need to be deferred. Please arrange a lift home (you’ll be in the back seat) and have help available for at least the first week.

Hospital Stay

Most foot operations are performed as day case procedures, meaning admission on the day of surgery and discharge that day, assuming all is well. I will discuss the possibility of overnight admission with you, if I feel it is necessary. Most operations are performed under a general anaesthetic, and while you’re asleep, I will give you an “ankle block” to numb your foot, so you should be comfortable when you wake up after surgery. The ankle block typically works for 6 to 8 hours which allows us to start oral painkilling tablets while the block is still working. You will be given oral painkillers approximately 4 hours after your surgery by the nurses on the day ward. This overlap is to ensure excellent and continued pain relief.

Upon Discharge

Upon discharge, we give you a prescription is for 3 types of painkillers:

 

  • Paracetamol (maximum 8 tablets per day)
  • An anti-inflammatory (e.g. Arcoxia)
  • A morphine type painkiller (e.g. Palexia)

 

You may need the full cocktail of painkillers for the first 48 hours. After this period, you can start to wean off them, one by one. Firstly stop the Palexia, then the anti-inflammatory, and finally the Paracetamol.

Please remember that you have had an operation and therefore your foot will become painful if you do not take the painkillers. It is much more difficult to manage your pain if you let it develop, so please avoid playing “catch-up”. You should stop all painkillers once you are comfortable.

Mobilisation following Surgery

I will tell you how much weight you can put on your ankle after your surgery. Most patients may “heel touch for balance”. This means resting the foot on the ground for balance only, and not putting any weight through the foot. Imagine you have glass or a stone in your shoe!

Most patients will be given a stiff Velcro shoe for moving around in order to protect the foot. This needs to be worn during the day, while you are up and about. In some cases, a cast or boot may be necessary, but I will discuss this with you before your operation. Our physiotherapist will educate and re-assure you prior to discharge and make sure you are safe and confident with your two crutches.

Elevation is Vital

The foot always swells after surgery. It is therefore very important to travel home in the back seat of the car, keeping the foot elevated. When at home, I suggest you elevate the end of the bed with books etc. or put a duvet under the mattress, to ensure continued elevation at night. It is fine to move about the house in the first week, but keep your movements to a minimum and once you are seated, elevate the foot again. This will limit your discomfort and help the wound to heal. When showering, avoid wetting the dressing. Some patients find the use of a dressing protector/sealed bag (available in most chemists) or cling-film very useful.

Driving

It is not safe to drive, until you are allowed to ‘full weight-bear’ without crutches. This usually takes a minimum of six weeks. It is important to get clear medical advice prior to driving again.

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