Person with Crutches

Post-operative instructions:
tarso-metatarsal joint (midfoot) surgery

If you have concerns during business hours, please contact South East Orthopaedic Surgery on 0484 739 550 or via email admin@southeastortho.com.au Please note voice mail messages and emails will be replied to by the next business day. If you have concerns outside of business hours, please contact the switchboard at Frankston Private Hospital on (03) 8796 1300. If you have having a limb or life threatening emergency, please dial 000 or present to the Frankston Public Hospital Emergency department. 

Wound management

For any surgery wound management is important. In particular, procedures on the achilles tendon are at risk of wound breakdown due to the tenuous blood supply in this area. Wound management following surgery is critical. Please keep your dressings and cast intact until review by your GP or surgeon, unless directed otherwise. You will need to keep the wounds dry by wrapping a plastic garbage or kitchen bag sealed with tape and an elastic bag during showers or bath. If you have excessive wound ooze through the dressings please contact the surgery to arrange the dressings to be changed. If you are concerned about the amount of wound ooze please contact the surgery as above, or present to Frankston Public Hospital Emergency department. If possible, please don’t commence antibiotics without discussing the situation with your surgeon. 

Swelling

Some swelling following your surgery is normal and may persist for months afterwards. Keep you foot elevated as much as possible, even if you are allowed to weight bear. We suggest icing the area (if practicable) for 20 minutes five times a day for the first week to help reduce inflammation. 

Weight bearing

You need to be non weight bearing while the wound heals. This is mean you need crutches, a frame or wheelchair (or a combination of all three) for mobility in this period. You will be able to weight bear 25% of your body weight in a boot provided there are no wound problems two weeks after surgery.

Driving

Unless instructed, you are unable to drive a minimum of six weeks following surgery. 

Post-operative appointment

Your post-operative appointment will be at our Frankston Rooms, 7 Foot Street, Frankston. This would normally be made for you prior to your surgery - please contact the practice if you are unsure of the time of your post-operative appointment. If you have travelled a significant distance and would prefer to see your GP for removal of sutures, this can be arranged. You will likely need to pay a consultation fee to your GP for this service (the cost of your post-operative appointment in our consultation rooms is included in your surgical fee). 

At your two-week appointment, your sutures will be removed. You will transition to a CAM boot with a medial arch support, which will be fitted by our practice nurse at this appointment. You can bring your own boot and/or arch support with you and we can assess it and make sure it is appropriate for your post-operative period. 

Physiotherapy

You will need to see a physiotherapist for rehabilitation once you have recovered from surgery, which is normally around twelve weeks post-operatively. If you do not have a regular physiotherapist, we have a network of practitioners we can recommend.

However, we do recommend you gently wiggle your toes immediately post-operatively whilst in the cast to prevent stiffness.

Smoking and alcohol cessation

It is important you smoke as little as possible (ideally not at all) to minimise wound problems and reduce risk of post-operative complications, including infection, following your surgery. 

We strongly recommend you avoid drinking alcohol after your surgery. Alcohol is a vasodilator and can increase swelling and redness, particularly in surgery to the foot and ankle. Patients who drink alcohol after their surgery also require more painkillers than those who do not drink alcohol.

Numbness

It is normal to have some numbness around the toes following surgery, particularly in the space between your first and second toes. This is due to a combination of swelling, local anaesthetic and possibly stretching of the nerves around your foot or ankle. Usually the numbness resolves after a few weeks, but rarely can be permanent. 

Pain

Some post-operative pain is normal following surgery. Your surgeon and anaesthetist work together to make sure you are as comfortable as possible on the ward and then when you are discharged home. If you have severe, relenting or escalating pain that is not relieved by pain-killers please contact your surgeon, GP or emergency department. 

Emergencies:

It is important you contact your surgeon, GP or emergency department if you have any of the following symptoms:

  • severe unrelenting pain not relieved by analgesia, rest, ice, compression or elevation

  • severe swelling of the foot or calf that does not resolve with elevation

  • redness around the wound or redness of the skin visible around the cast

  • discharge from the wound or pin sites

  • fevers, night sweats or unexplained shaking or feeling cold

  • shortness of breath or chest pain

We wish you well with your recovery post-operatively and look forward to seeing you at your two-week post-operative appointment.