Post-Orthopedic Foot Surgery Care
Elevate your foot above heart level while in bed and apply ice intermittently for the first 48-72 hours to reduce swelling and pain, while following your surgeon's specific wound care instructions.
Elevation Protocol
- Keep your foot elevated above heart level when lying down or sitting, using pillows or a foam wedge to maintain this position consistently 1.
- Elevation reduces limb edema, which is critical for wound healing and preventing complications after orthopedic surgery 1.
- Multilayer compression therapy combined with elevation has been shown to reduce ankle and hindfoot edema by 22-23% within two days postoperatively, significantly better than ice alone 2.
Ice Application
- Apply ice intermittently (typically 15-20 minutes on, 40-60 minutes off) during the first 48-72 hours to manage pain and swelling 2.
- Ice therapy is the standard treatment but is less effective than compression bandaging for edema reduction 2.
- Never apply ice directly to skin; use a barrier such as a towel to prevent cold injury.
Wound Care and Inspection
- Inspect the surgical wound daily for signs of infection including increased redness, warmth, purulent drainage, or worsening pain 1.
- Keep the surgical dressing clean and dry unless your surgeon provides different instructions 1.
- Do not remove the initial surgical dressing until instructed by your surgeon, as premature removal increases infection risk 1.
- If a rigid dressing or cast was applied, do not get it wet and report any foul odor, increased pain, or fever immediately 1.
Weight-Bearing Restrictions
- Follow your surgeon's specific weight-bearing instructions strictly - these vary dramatically based on the type of surgery performed 1.
- Most orthopedic foot surgeries require non-weight-bearing or protected weight-bearing for 4-6 weeks to allow proper healing 3.
- Use crutches, a walker, or knee scooter as prescribed to avoid placing weight on the operative foot 4.
Critical Warning Signs
Contact your surgeon immediately if you experience:
- Fever above 101°F (38.3°C) 1
- Increasing pain not controlled by prescribed medications 5
- Foul-smelling drainage or pus from the wound 1
- Excessive swelling that worsens despite elevation 2
- Numbness, tingling, or color changes in the toes (blue, white, or very pale) 4
- Inability to move your toes 6
Risk Factor Awareness
Be especially vigilant if you have:
- Age ≥60 years - associated with 9-fold increased risk of wound complications 7
- Tobacco use - associated with 49-fold increased risk of wound complications 7
- Diabetes - requires meticulous wound monitoring and may have prolonged healing times of several weeks 3
- Peripheral vascular disease - may require additional vascular assessment if healing is delayed 4
Common Pitfalls to Avoid
- Do not walk barefoot even indoors, as this increases risk of trauma to the healing foot 1.
- Avoid dependent positioning (letting the foot hang down) for prolonged periods, as this dramatically increases swelling 2.
- Do not use heating pads or hot water bottles on the operative foot, as sensation may be altered and burns can occur 1.
- Never ignore mild pain - patients routinely report mild to moderate pain even with pain medications, and additional interventions may be needed 5.