PODIATRIC SURGERY —
Preparation for surgery
If you decide to have foot surgery, Dr. Wexler or your personal physician will assess your general health. You may need preoperative clearance from your primary care or treating physician. Conditions such as diabetes, rheumatoid arthritis, or circulatory difficulties could negatively impact your healing and could increase postoperative pain.
Be sure to tell Dr. Wexler what medications you take regularly, including herbal or natural remedies. Follow her instructions on which medications you should or should not stop taking before surgery.
You may or may not be required to have blood tests, cardiac testing, chest X-ray, or urinalysis in addition to foot X-rays or other imaging studies.
The usual surgical outcome
Most patients have a significant decrease in pain after surgery (once healed) and in the case of bunion or hammertoe surgery, a better alignment of those structures. Your outcome will depend on how severe your deformity was before surgery, your medical condition, your age, and your compliance with postoperative instructions. In general, there may be some degree of swelling of the foot for three to six months following surgery.
Dr. Wexler will follow you closely during this postoperative period and recommend exercises or physical therapy to improve foot strength and range of motion. Depending on the extent of your condition, you can expect a recovery period of at least six to eight weeks, or longer. During that time you may be required to wear a special shoe or boot, or even a cast to provide stability to the foot. She will tell you when you can walk on your foot again.
Risks of surgery and potential complications
Even the most minor surgical procedure has a degree of risk. Dr. Wexler will go over the most common problems that have occurred after foot surgery. These include infection, recurrence of pain, nerve damage (which could be chronic), recurrence of the deformity, poor healing, bleeding, scarring, blood clots, or allergic reaction. Most complications are treatable, but may increase your recovery time. Although it is extremeley rare, you could experience stroke, heart attack, loss of a limb, or death.
Dr. Wexler will go over all these possibilities with you so you have a full picture of what to expect. After she has described these potential risks to you, you will be asked to sign a form called an informed consent form. Be sure to ask questions if you are uncertain about what you are being told, and make sure your questions are answered to your satisfaction. Your signature on this form indicates that your questions have been answered and you have been informed of the risks and potential complications of bunion surgery.
Types of surgery
Dr. Wexler will determine and explain which type of surgical procedure is right for you.
Most surgical procedures are performed outpatient. You will be asked to arrive at the outpatient facility one hour before the surgery, and can usually go home an hour or two after the surgery. The procedure itself will usually take about one to two hours.
The type of anesthesia used will depend on the type of surgery done, your condition, and the anticipated length of the surgery. Most are done with a local anesthetic agent to numb the area and an IV anesthesia. In some cases you may have general anesthesia. After surgery you will go to the recovery room. You will have one or more scars after the surgery, depending on the type of surgery performed. They will slowly fade over many months.
It is important that you follow Dr. Wexler’s instructions completely following the surgery. For many surgeries, you have scheduled follow up visits with Dr. Wexler for several months.
You should call the office immediately if you notice any of the following:
- Fever of 101 degrees Farenheit or higher and/or chills;
- Persistent, uncomfortable warmth or redness around the dressing;
- Persistent or unbearable pain;
- Nausea and/or vomiting;
- Pain, redness, or swelling in one or both legs;
- Feeling anxious;
- Chest pain, shortness of breath, or coughing.
You will be sent home after surgery with a dressing. You may receive a cast or a special surgical shoe (or both) to wear for some time. You should notify Dr. Wexler if your dressing comes off or gets wet, or if you notice blood or other drainage on it. It is very important to leave the dressings in place, when instructed to do so, and not get them wet or dirty.
Postoperative office visits
Ordinarily you will see Dr. Wexler three or four days after surgery for a dressing change and postoperative X-rays. About two weeks after surgery Dr. Wexler will remove the stitches. Once the stitches are removed, you may be able to bathe normally. Be sure to ask Dr. Wexler for instructions if anything is unclear.
Dr. Wexler will let you know when you can start to wear shoes, and the best type for you. You should continue to faithfully do any exercises she has given you. Apply skin emollients, such as aloe vera or vitamin E, around the healing wound as directed. Dr. Wexler will instruct you on when you can walk, drive, and resume other activities.
The postoperative course varies for individuals. For some patients, swelling may last longer and healing may take more time than anticipated. You should try to keep your foot elevated as much as possible immediately after the surgery. Dr. Wexler will instruct you to apply ice to your foot for the first several days post op. Ice will be applied over the bandage for 10-15 minutes, removed for 15-20 minutes, and repeated throughout the day to reduce pain and swelling. You will experience some swelling in your foot for several months following the surgery.
Be sure to engage in the exercises that Dr. Wexler recommends. These exercises will help restore your range of motion and your foot strength. Do not engage in any strenuous or weight-bearing exercises that are not recommended by Dr. Wexler.