Ankle/Hindfoot Recovery Guide

ANKLE / HINDFOOT SURGERY POST-OPERATIVE INSTRUCTIONS

General Anesthesia:

If you were put to sleep for your surgery and are not staying in the hospital, you should have someone at home to assist you for at least the first 24 hours. You may feel sleepy throughout the day.
Do not drive, operate machinery, or return to work for at least 24 hours after receiving anesthesia.

Diet:

Start with clear liquids and gradually return to your regular diet as tolerated.

Pain Control:

Take your pain medication as prescribed, and try to take it with food.
Use ice and elevate your leg (“toes above the nose”) to help manage pain and swelling.
If you received a nerve block, do not leave ice on your foot for more than 15 minutes at a time. Follow all instructions provided by the anesthesia team regarding the nerve block.

Wound Care:

Some mild bleeding or oozing from the bandages is expected. Keep the dressings dry and reinforce them with an ACE wrap or gentle pressure if needed until the bleeding stops.
Swelling in the foot is common. Your splint is open in the front to allow for swelling.
If your toes become numb, painful, or turn bluish, slightly loosen the bandages or splint.
Ice and elevation (“toes above the nose”) will help minimize swelling and bleeding.
Do not remove or change your bandages before your first post-operative visit (typically in two weeks).

Activity:

You will use crutches or a walker to help with mobility for the first several weeks.
Starting on the third day after surgery, you may rest your splint or boot on the ground for balance only.
Elevate your leg (“toes above the nose”) at all times except for 5 minutes each hour, during which you should get up and move using your crutches or walker.
Sit upright for meals and walk to the bathroom as needed. If traveling by air, stand and move around for 5 minutes every hour.
At your two-week follow-up, you will receive a hard cast or boot, and further weight-bearing instructions will be given.

Note: Numbness in your foot or leg may continue for several days due to the nerve block.

Call Our Office If You Experience:

  • A wet or soaked splint, cast, or dressing

  • Swelling in the foot, ankle, or calf that is not relieved by elevation

  • Increased numbness or tingling in your foot

  • Calf pain that is tender and warm to the touch

  • Fever over 101°F or chills

  • Worsening pain, with or without activity

  • Drainage, redness, or warmth at the incision site

  • The incision begins to open or separate

Who to Contact:

  • During office hours: Call (949) 722-5037

  • After hours or weekends: Call (949) 722-5035 to speak with the on-call nurse or physician

Your Follow-Up Appointment:

Schedule a follow-up appointment 10 to 14 days after surgery with Dr. Nicholas Wegner.

  • Durable Medical Equipment (DME):

    • Posterior splint initially → Transition to walking boot

    • Crutches or knee scooter for non-weightbearing phase

    Weight-bearing Status:

    • Non-weightbearing (NWB) for ~2 weeks

    • Transition to partial weight-bearing (PWB) in boot after sutures are removed and X-rays show progress

    • Gradual return to full weight-bearing by ~6 weeks (based on healing)

    Return to Work:

    • Desk jobs: ~2–3 weeks (if NWB is manageable)

    • Active/standing jobs: ~8–12 weeks, depending on healing

    Driving:

    • Left foot surgery: ~2–3 weeks if no narcotics

    • Right foot surgery: Once out of the boot and can safely control pedals (~6–8 weeks)

    Physical Therapy:

    • Begins ~4–6 weeks post-op

    • Focus on ankle mobility, strength, and balance

  • Durable Medical Equipment (DME):

    • Splint → Boot

    • Crutches or knee scooter

    Weight-bearing Status:

    • Strict NWB for 4–6 weeks

    • Progress to PWB, then full weight-bearing (FWB) in boot after radiographic healing (~6–8 weeks)

    Return to Work:

    • Desk jobs: 3–4 weeks if mobility is manageable

    • Active/physical jobs: ~10–12 weeks

    Driving:

    • Right foot: ~8 weeks

    • Must be out of boot and have full control of foot and ankle

    Physical Therapy:

    • Starts ~6–8 weeks post-op

    • Focus on regaining motion, strength, and gait normalization

  • Durable Medical Equipment (DME):

    • Splint → Boot

    • Crutches/knee scooter initially

    Weight-bearing Status:

    • NWB for 6–8 weeks due to more complex injury

    • Gradual transition to FWB in boot after X-ray confirmation of healing

    Return to Work:

    • Desk jobs: ~3–4 weeks

    • Physically demanding jobs: ~12–16 weeks, sometimes longer depending on residual stiffness or swelling

    Driving:

    • Right foot: Usually safe after ~8–10 weeks

    • Must be off pain meds and out of the boot, with sufficient strength and range of motion

    Physical Therapy:

    • Starts ~6–8 weeks

    • Focus on ankle mobility, proprioception, and strength

  • Durable Medically Equipment (DME):

    • Long leg splint or brace initially

    • Transition to CAM boot or supportive brace as healing progresses

    • Crutches or walker

    Weight-bearing Status:

    • NWB or toe-touch weight-bearing (TTWB) for 6–8 weeks

    • Progress to PWB → FWB over 10–12 weeks depending on healing

    Return to Work:

    • Desk job: 2–4 weeks

    • Active/manual labor: 3–4 months

    Driving:

    • Right leg: ~8–12 weeks (depending on strength and reaction time)

    • Left leg: ~3–4 weeks, as long as no narcotics are used and you're comfortable operating a vehicle

    Physical Therapy:

    • Often begins around 6–8 weeks post-op

    • Focus on lower leg strength, gait training, and mobility

  • Durable Medical Equipment (DME):

    • Post-op bandage → Ankle brace or compression sleeve

    • Crutches for short-term use (if needed)

    Weight-bearing Status:

    • Weight-bearing as tolerated (WBAT) same day or within 1–3 days post-op

    • May use crutches or cane for comfort during the first week

    Return to Work:

    • Desk job: 1–3 days

    • Active job: 1–2 weeks depending on symptoms and findings

    Driving:

    • 1–3 days (as soon as off narcotics and safe foot control)

    Physical Therapy:

    • Usually starts within the first week

    • Focus on restoring motion and strength quickly

    Full Recovery:

    • ~2–4 weeks for basic recovery

  • Durable Medical Equipment (DME):

    • Initial splint → Boot or cast → Transition to ankle brace/shoe

    • Crutches, walker, or knee scooter during NWB phase

    Weight-bearing Status:

    • NWB for ~2 weeks

    • PWB in boot ~2–4 weeks post-op (surgeon-dependent)

    • FWB in boot by 6 weeks if X-rays show healing

    Return to Work:

    • Desk job: 2–3 weeks

    • Standing/manual jobs: 10–12 weeks or more

    Driving:

    • Left ankle: 3–4 weeks

    • Right ankle: ~6–8 weeks (once out of boot and safe to operate pedals)

    Physical Therapy:

    • Starts ~4–6 weeks post-op

    • Focus on range of motion, strength, and gait retraining

    Full Recovery:

    • 4–6 months for most activities

    • 12 months for full return to higher-level function

  • Durable Medical Equipment (DME):

    • Splint → Cast → CAM boot

    • Knee scooter or crutches for NWB phase

    Weight-bearing Status:

    • Strict NWB for 6–8 weeks

    • Progress to PWB → FWB as X-rays confirm fusion (typically 8–12 weeks)

    Return to Work:

    • Desk job: 3–4 weeks

    • Physical/standing work: 3–4 months

    Driving:

    • Left foot: 6–8 weeks

    • Right foot: 10–12+ weeks, based on weight-bearing status and mobility

    Physical Therapy:

    • Begins around 8–10 weeks, once fusion is confirmed

    • Focus on strengthening, balance, and gait training

    Full Recovery:

    • 4–6 months for walking

    • Up to 12 months for full return to all activities

  • Durable Medical Equipment (DME):

    • Splint in plantarflexion → CAM boot with heel lifts

    • Crutches or knee scooter

    Weight-bearing Status:

    • NWB for 2–3 weeks

    • Progress to PWB with boot and heel lifts ~3–6 weeks

    • FWB in boot by 6–8 weeks

    Return to Work:

    • Desk job: 2–3 weeks

    • Physical job: ~3–4 months depending on strength and mobility

    Driving:

    • Left side: ~3 weeks

    • Right side: 6–8 weeks (must be out of boot and safe with brakes)

    Physical Therapy:

    • Starts ~4–6 weeks post-op

    • Emphasizes protected stretching, gradual strengthening, and return to activity

    Full Recovery:

    • ~6 months to return to light activity

    • 9–12 months for full sports return or high-impact activity

  • Durable Medical Equipment (DME):

    • Splint → Boot

    • Crutches or scooter depending on extent of surgery

    Weight-bearing Status:

    • NWB for 4–6 weeks (longer if large excision or joint involvement)

    • Gradual progression to PWB → FWB by 6–10 weeks

    Return to Work:

    • Desk job: 2–3 weeks

    • Active/standing work: 10–12 weeks

    Driving:

    • Left foot: 2–3 weeks

    • Right foot: 6–8+ weeks, based on foot control and weight-bearing status

    Physical Therapy:

    • Begins after weight-bearing begins

    • Focus on ankle motion, joint stabilization, and gait training

    Full Recovery:

    • 3–6 months depending on size of excision and joint health