Lower Extremity Surgery Postoperative Instructions

Michael E. Higgins, M.D.

Weight bearing

  • Dr. Higgins will instruct you before surgery as to how much weight you may put on your leg

Ice and Elevation

  • Ice will be your friend for the first several days after surgery.  Icing the operative site will help to minimize swelling and help relieve pain or discomfort.  A bag of ice, or frozen vegetables wrapped in a towel works well.  Apply ice to and replace as needed.  If your skin is too cold take a break, but otherwise don’t bother with the 20 minutes on 20 minutes off routine.
  • Elevating your leg preferably to chest level will help control swelling and pain

Pain Medication/Prescriptions

  • A narcotic pain medication will be prescribed for pain control at home, usually hydrocodone.  Take as needed for pain control.  In the first 3-4 days after surgery it is usually best to take the medicine if you start to have pain to “stay in front of the pain”.  If you are not in pain do not take the medicine.  Beyond the first few days after surgery most patients are able to significantly decrease their use of narcotic pain medications.
  • An anti-nausea medicine is prescribed, usually Phenergan. Take this medication if the pain medicine makes you nauseous.
  • If you are prone to constipation or have experienced constipation with pain medication in the past over the counter stool softeners and or milk of magnesia should be started with pain medication after surgery and taken as needed to avoid constipation.
  • An anti-inflammatory medication is prescribed, usually Meloxicam or Mobic.  This medication is for both relieving inflammation as a bonus it helps with pain although it is not a narcotic.  This medication should be taken for 30 days after surgery, a refill is provided on the script to be used if you notice increased pain after completing the first 30 days. 

 

  • An adult Aspirin (325mg) should be taken daily for 4 weeks after surgery.  There is a small risk of developing a blood clot in your leg after surgery and aspirin diminishes this risk.

 

Surgical Dressing

  • If the dressing is too tight you can remove the ace wrap and reapply. 
  • If you are in a cast or splint do not remove unless instructed to do so by Dr. Higgins.
  • Some bloody drainage may soak through the dressing.  If this occurs reinforce the dressing with gauze and an ace wrap.

Bruising

  • Bruising on the thigh, calf or ankle may develop after surgery.  Ice these areas as needed.

 

Showering

  • Showering in a cast or splint for the first 2 weeks after surgery is generally a bad idea (even in a cast bag) and sponge baths are recommended.  If your case is an exception Dr. Higgins will inform you before surgery.

 

Fevers

  • Low grade fevers (less than 101) are common after surgery and generally last only a short period of time.  These fevers are most often caused by mucus in your lungs.  Deep breaths, coughing, and moving around a bit are usually all that is needed.  If you are having fevers shortly after surgery the chances of that fever coming from an infection at the surgical site is very low.

 

Driving

  • There is not a time limit that must be met to drive.  You should not drive with a cast or splint on your right foot.  To drive you need to be able to operate the vehicle safely.  That means you should not take narcotic pain medicine and drive.  You need to be comfortable and confident you can slam on the brakes in an emergency etcetera.  If you are not sure you are ready to drive go to an empty parking lot and practice first.

 

Exercises

  • While seated, bend and straighten your knee as much as comfort will allow 20 repetitions 3 times daily.  This helps to reduce stiffness in the knee.
  • While seated, tighten the thigh muscles (quadriceps) for 5 seconds and then relax.  Repeat 20 times 3 times daily.  This helps to reawaken the thigh muscles which may be a little weak right after surgery.
  • Short walks can be helpful and are encouraged.  Start with 1/8 or 1/4 mile a few days after surgery and slowly increase the distance daily. 

 

Please Call the Office with Significant Concerns

  • 757 827-2480