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Hospitalisation

INFORMATION REGARDING OPERATIONS ON THE FORE FOOT

Most probably you will undergo a  loco-regional anesthesia (which in some cases needs in addition a very light general anesthesia)  which will last for  many hours (foot becoming insensible sometimes soft without tonus) which will mean that this will act whilst the pains are at the maximum level.

As soon as the effect of the anesthesia will dissipate you will have to take over with the prescribed pain killers.

If necessary, the surgeon will show you how to make and undo the first bandage as well as the next ones. Then as appropriate you will be seen on a consultation on the 14th or 21st day for a clinic control.

In between should you have the slightest problem we remain at your disposal.

 

BEARING    How to walk

After the operation you will be walking with a  heel bearing shoe and in certain cases (especially if you are operated on a day surgery basis ) in order to ease the weight on the foot you will be using  crutches for one or two days ( on the operated side if using only one).

For this before you set foot on the ground, you will move your ankle in order to have the heel touching the ground first. Practice first in a sitting position. Then put your foot in the special shoe and gradually put weight on the heel.

When walking  avoid a natural way of walking, folding quicker the knee and walk on a flat surface as much as possible.

Use the heeled bearing shoe is important even if at the beginning you feel some pain, and this in order to activate the blood circulation and avoid oedema and a phlebitis (3 to 4 minutes, 10 to 15 times a day)

Before the anaesthesia ends, if the  motor activity is not recovered (i.e. the movement of the ankle) be extremely careful when using the bearing not to strain your ankle.

 

The PAIN:  How to soothe it?

During the consultation painkillers would have been prescribed for you. Take them as soon as the pain appears or as soon as you leave the private hospital. The bearing strongly contributes to the pain unless you measure it and avoid overusing it (frequent resting times, legs kept raised). Raise the bed feet by 10 to 15 cms and avoid the weight of the blankets. During the day apply an iced pocket on the bandage 15 to 20 minutes every 2 hours.

 

MORNING WASHING: How to proceed ?

Avoid to wet the bandage because of the risk of an infection.

It is advised to clean the visible parts of your foot.

For the shower in the morning first put on the shoe then sit down on a stool. The suture threads are dissolvable (between 3 to 5 weeks). From the 3rd week if the scar looks good you may wash the whole foot with a soap. Baths will only be authorised when the threads then the scar crust disappears. Take a few minuts foot bath morning and evening  during  all over the foot drawing  the toes  in the axis giving a massage to the dorsal and the plantar sides of the foot.

 

MOBILITY OF THE TOES   SELF REEDUCATION TO START AS SOON AS POSSIBLE

After having massaged the toes and the foot with an anti-friction cream (like sweet almond oil)

On your bed lying down

Move your toes (at the same time moving your fingers can help)

Then placing the operated foot on the opposite knee press with the opposite hand under the forefoot in order to raise the foot. Then with the other hand bring down the toes at maximum  one by one (this can be uncomfortable but you must insist without suffering for too much pain). Finally bend them actively towards the dorsal part of the foot with the opposite hand (sitting on the bed, operated foot resting outside, knee and hip bent).

Sitting position

Place the forefoot on a tennis ball, make it roll and try to grasp it with your toes. Roll the foot on a wood cylinder (for example a rolling pin for pastries). This helps the resorption of the oedema.

Put the foot flat on the ground as well as the pulp of the toe. Place the index finger in the first commissure (between the 2nd toe and the big toe) in order to block it. The big toe straight and aligned press the pulp of the toe on the ground in order to feel a contraction of the inner foot muscles (Do not raise the heel during this exercise). This strengthens the muscles of the foot and aligners of the big toe.

Try to cross the toes with the fingers of the opposite hand (as done when crossing the fingers). First you may feel some pain but it is ideal to recover the flexibility of the toes.

-Standing up

Raise the toes towards the ceiling. Walk on the heels for a few meters.

 

GENERAL RECOMMENDATIONS

Things Forbidden

  • Wet the bandage during the 2 or 3 first weeks
  • Walk on tiptoe. Walk for a long time and walk quickly, run and jump
  • Forget to massage and to mobilize the foot and the toes, to ice the operated part of the foot. Sitting or standing for long periods because this could help the creation of an oedema and a venous stasis

Guidance for the shoe fitting

  • the operated foot will be midly swollen for a long time and the oedema increases during the day along with the activity. Ask for an anti-oedema treatment if you feel it necessary.
  • Should you feel heavy legs one day wear compression stockings
  • In the morning wear the adapted shoe, change once or twice during the day for a more comfortable
  • shoe
  • Upon the bone consolidation achieved, you may wear wedge heel shoes (3 to 4 cms)

Driving a car    It is possible as soon as the bone consolidation is completed (the 3rd or 4th week)