From the Guidelines
For a post-operative shoe contusion to the foot, the appropriate diagnosis code would be S90.0- (Contusion of ankle and foot) with the appropriate laterality specified (right, left, or bilateral). When selecting a post-operative shoe to prevent or treat a contusion, considerations should include the use of a prefabricated shoe with a roomy and soft upper, such as a post-operative shoe, as described by S. A. Bus et al. 1. This type of shoe can provide the necessary comfort and protection for the foot after an operation.
Key characteristics of an ideal post-operative shoe for contusion prevention or treatment include:
- A roomy and soft upper to reduce pressure on the foot
- Adequate padding to cushion the foot and ankle
- A removable insole to allow for customization or replacement if necessary
- A rocker or roller outsole configuration to reduce stress on the foot and ankle during walking
In terms of specific shoe types, options may include:
- Post-operative shoe: A prefabricated shoe with a roomy and soft upper, designed for wear after foot surgery
- Orthopaedic shoe: A custom-made shoe designed to provide support and protection for the foot
- Removable (cast) boot/walker: A prefabricated, removable boot with a padded interior and adjustable insole, which may be used for more severe contusions or post-operative care
Treatment for a post-operative shoe contusion typically involves rest, ice, compression, and elevation (RICE protocol), along with appropriate pain management using acetaminophen or NSAIDs if not contraindicated, as supported by general medical knowledge and practices. The medical record should clearly establish that the contusion resulted from the post-operative shoe, and include details about the exact location of the contusion, severity, and associated symptoms.
From the Research
Diagnosing and Treating Post-Op Shoe Contusion to the Foot
To diagnose and treat a post-op shoe contusion to the foot, the following steps can be taken:
- Assess the severity of the contusion and check for any signs of infection, such as redness, swelling, or purulent discharge 2
- Use the PRICE principle (protection, rest, ice, compression, and elevation) to guide treatment, as recommended for soft tissue injuries 3, 4, 5
- Consider using rest, ice, compression, and elevation (RICE) therapy to reduce swelling and promote healing, although the evidence for its effectiveness is limited 5
- For muscle contusion injuries, treatment options may include anti-inflammatory medications, corticosteroids, operative repair, and exercise protocols, although more research is needed to determine the best course of treatment 6
Treatment Options
Some possible treatment options for post-op shoe contusion to the foot include:
- Prophylactic antibiotic therapy to prevent infection, as studied in 2
- RICE therapy to reduce swelling and promote healing, as described in 4 and 5
- Protection and rest to allow the contusion to heal, as recommended in 3
- Elevation to reduce swelling, as suggested in 4 and 5
- Compression to reduce swelling and promote healing, as recommended in 3 and 4
Considerations
When treating a post-op shoe contusion to the foot, it is essential to consider the following:
- The severity of the contusion and the presence of any signs of infection 2
- The patient's overall health and medical history 2
- The need for further evaluation or treatment, such as imaging studies or surgical intervention 6
- The importance of patient education and follow-up care to ensure proper healing and prevent complications 3, 4, 5