Midfoot Recovery Guide
MIDFOOT 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 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. Applying ice and elevating your leg (“toes above the nose”) will help reduce 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 any specific instructions from the anesthesia team regarding your nerve block.
Wound Care:
Some mild bleeding through the bandages is normal. Keep your dressings dry. You may reinforce them with an ACE wrap or apply pressure if bleeding continues.
Swelling in your foot and ankle is expected. Your splint is open in the front to accommodate this. If your toes become numb, painful, or bluish, slightly loosen the bandages or splint.
Continue to use ice and elevate your leg to reduce swelling and bleeding.
Do not remove the bandages before your first post-operative visit (usually in two weeks).
Activity:
You will use crutches for balance and mobility for the first several weeks. Starting on the third day after surgery, you may gently rest your splint or boot on the ground for balance only.
Elevate your leg (“toes above the nose”) except for brief periods: every hour, get up for five minutes using crutches or a walker.
Sit upright for meals and walk to the bathroom as needed. When flying, move around for five minutes each hour.
A hard cast or boot will be placed at your two-week follow-up, and further weight-bearing instructions will be discussed then.
Note: Your foot and leg may feel numb for several days after surgery 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 above 101°F, or chills
Increased pain, with or without activity
Redness, warmth, or drainage at the incision site
The incision opens or separates
Who to Contact:
During office hours: Call (949) 722-7038
After hours or on weekends: Call (949) 722-5035 to speak with the on-call nurse or doctor
Your Follow-Up Appointment:
Schedule your follow-up appointment 10 to 14 days after surgery with Dr. Nicholas Wegner.
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Durable Medical Equipment (DME):
Post-op shoe or walking boot
Crutches or walker (optional, for balance early on)
Weight-bearing Status:
Heel weight-bearing immediately post-op in post-op shoe or boot
Full Weight Bearing in boot as tolerated (often by 2–3 weeks)
Transition to supportive shoe by 6–8 weeks
Return to Work:
Desk job: ~1–2 weeks
Active job: ~6–8 weeks, depending on swelling and pain tolerance
Driving:
Left foot: 1–2 weeks
Right foot: ~4–6 weeks (once comfortable, off narcotics, and out of boot)
Physical Therapy:
May begin ~4–6 weeks post-op (as needed)
Focus on toe range of motion (pre-fusion), gait, and strength
Full Recovery:
~8–12 weeks for basic activity
4–6 months for complete recovery and joint fusion
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Durable Medical Equipment (DME):
Post-op bunion shoe
Toe spacer or splint (as directed)
Assistive device optional (crutches for balance in first few days)
Weight-bearing Status:
Heel weight-bearing in post-op shoe immediately
Transition to full weight bearing in supportive shoe by 4–6 weeks
Return to Work:
Desk job: 1–2 weeks
Active job: 6–8 weeks, depending on swelling and footwear
Driving:
Left foot: ~1 week
Right foot: ~4–6 weeks, after safe shoe wear and reaction time return
Physical Therapy:
Often not required
Home exercises for toe mobility and strengthening as directed
Full Recovery:
6–8 weeks for comfort in shoes
Swelling may persist up to 3–6 months
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Durable Medical Equipment (DME):
Boot
Crutches, knee scooter, or walker
Weight-bearing Status:
Strict non-weight bearing for 4–6 weeks
Progressive weight bearing in boot after initial healing
Full weight bearing in boot by ~8 weeks (based on X-rays)
Return to Work:
Desk job: ~2–3 weeks
Active work: 10–12 weeks, depending on fusion and gait
Driving:
Left foot: ~3–4 weeks
Right foot: ~8–10 weeks (once full weight bearing and out of boot)
Physical Therapy:
Begins around 8–10 weeks
Focus on balance, foot strength, and walking mechanics
Full Recovery:
3–6 months for walking comfortably
Up to 12 months for full activity, including sports
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Durable Medical Equipment (DME):
Post-op shoe or CAM boot
Crutches or walker (if non-weight bearing early on)
Toe splint or buddy taping (as directed)
Weight-bearing Status:
Often non-weight bearing or heel weight bearing for 2–3 weeks
Gradual transition to full weight bearing by 4–6 weeks in boot
Supportive footwear thereafter
Return to Work:
Desk job: ~2 weeks
Active job: ~6–10 weeks, depending on swelling and healing
Driving:
Left foot: ~2–3 weeks
Right foot: ~6–8 weeks (once walking normally and off pain meds)
Physical Therapy:
Begins ~4–6 weeks post-op
Focus on toe alignment, strengthening, and gait correction
Full Recovery:
2–3 months for basic function
Up to 6 months for complete healing and return to high activity
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Durable Medical Equipment (DME):
Post-op shoe or boot
Crutches if needed for comfort (short term)
Weight-bearing Status:
Typically WBAT (weight-bearing as tolerated) in post-op shoe
Transition to regular shoe by 4–6 weeks
Return to Work:
Desk job: 1–2 weeks
Standing job: 4–6 weeks depending on comfort
Driving:
Left foot: ~1 week
Right foot: ~4–6 weeks (depending on swelling and ability to control pedal)
Physical Therapy:
Usually not required
May be recommended for gait retraining if significant bone excision
Full Recovery:
~6–8 weeks for most activities
Full comfort and function may take 3+ months
