Forefoot/Toe Recovery Guide

FOREFOOT / TOE 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 drowsy throughout the day.
Do not drive, operate heavy machinery, or return to work for at least 24 hours after anesthesia.

Diet:

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

Pain Control:

Take your prescribed pain medication as directed, and try to take it with food.
Apply ice to the operative area and keep your leg elevated (“toes above the nose”) to help reduce swelling and pain.
If you received a nerve block, do not apply ice for more than 15 minutes at a time. Follow all instructions provided by the anesthesia team regarding your nerve block.

Wound Care:

For the first few days, keep your leg elevated (“toes above the nose”) as much as possible to control swelling. You may apply ice intermittently.

You may remove your dressing after 5 days. At that point, you can cover the small wounds with Band-Aids or small dressings.
If steri-strips (white or tan adhesive strips) are present, do not remove them—they will fall off on their own.

It is okay to shower, but do not submerge your leg in water (no hot tubs, baths, or swimming pools) until your stitches are removed.

If you keep the dressing on longer than 5 days, ensure it stays dry. Cover your leg with a garbage bag sealed at the top or set your leg on the edge of the tub while bathing. Reusable waterproof cast covers are also available at most retail pharmacies.

Activity:

Use crutches or a walker for balance during the first two weeks after surgery.
Starting on day 3, you may begin heel weight-bearing only in your post-operative shoe—keep pressure off the front of your foot.

For the first 48 hours, elevate your leg (“toes above the nose”) as much as possible. Every hour, stand and move around for 5 minutes using crutches or a walker.
Sit upright to eat meals and walk to the bathroom as needed.

If you’re riding in a car, stop every 45 minutes to get out and move around for 5 minutes. If flying, get up and walk every 45 minutes.

Your foot and leg may feel numb or tingly for several days—this is likely due to the nerve block and should gradually resolve.

Call Our Office If You Experience:

  • A wet or soaked splint, cast, or dressing

  • Swelling in the foot, ankle, or calf that doesn’t improve with elevation

  • Increased numbness or tingling in your foot

  • Calf pain that is tender and warm to the touch

  • Fever over 101°F or chills

  • Increased pain, with or without activity

  • Redness, warmth, or drainage at the incision site

  • The incision begins to open or separate

Who to Call:

  • During office hours: Call (949) 722-7038

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

Your Follow-Up Appointment:

Schedule your post-operative visit 10 to 14 days after surgery with Dr. Nicholas Wegner.

  • Durable Medical Equipment (DME):

    • Post-op shoe

    • Toe splint, buddy tape, or pin cap if hardware used

    • Crutches (optional for balance in first few days)

    Weight-bearing Status:

    • Heel weight-bearing immediately in post-op shoe

    • Usually WBAT (weight-bearing as tolerated)

    • Return to regular shoes by 4–6 weeks if swelling allows

    Return to Work:

    • Desk job: ~1 week

    • Active/standing job: ~4–6 weeks depending on healing and footwear

    Driving:

    • Left foot: ~1 week

    • Right foot: ~3–4 weeks (once comfortable and in proper footwear)

    Physical Therapy:

    • Often not required

    • Home stretching and toe movement exercises may be recommended

    Full Recovery:

    • 4–6 weeks for daily activities

    • Up to 3 months for swelling to fully resolve

  • Durable Medical Equipment (DME):

    • Post-op shoe

    • Crutches or cane for support if needed early on

    • Toe pin (temporary) or small screw (internal hardware)

    Weight-bearing Status:

    • Heel weight-bearing in post-op shoe

    • WBAT usually allowed unless surgeon instructs otherwise

    • Out of post-op shoe by ~4–6 weeks

    Return to Work:

    • Desk job: ~1 week

    • Standing/manual work: ~4–6 weeks

    Driving:

    • Left foot: ~1–2 weeks

    • Right foot: ~4 weeks (after pin removal or when fusion is stable and comfortable)

    Physical Therapy:

    • Often not required unless gait is altered

    • Focus is typically on maintaining mobility of adjacent toes and foot strength

    Full Recovery:

    • 6–8 weeks for most daily activities

    • Full fusion may take 8–12 weeks

  • Durable Medical Equipment (DME):

    • Post-op shoe or CAM boot (if more extensive)

    • Crutches or cane (optional, for comfort)

    Weight-bearing Status:

    • WBAT in post-op shoe immediately after surgery

    • Transition to normal footwear by ~4–6 weeks, depending on swelling and comfort

    Return to Work:

    • Desk job: ~1–2 weeks

    • Active/standing job: ~4–6 weeks

    Driving:

    • Left foot: ~1 week

    • Right foot: ~3–4 weeks (as long as pain-free and in a normal shoe)

    Physical Therapy:

    • Not always required

    • Gait training or strengthening may be recommended for more complex cases

    Full Recovery:

    • ~6 weeks for most normal activity

    • Up to 3 months for full return to high-impact tasks or prolonged standing