• Foot is wrapped in a below knee cast or splint with bandages depending on swelling.
• Elevate the leg on some pillows when awake however when sleeping elevate the base of the bed with 2 bricks or thick books so that the limb does not fall of the pillow at night and you wake up swollen.
• Take pain and DVT prophylaxis medication as prescribed.
• Expect numbness in foot 4-12 hours, followed by pain for usually one more day.
• Do not allow foot to hang down and apply ice packs when needed.
• If you are travelling, move the toes as much as possible to stimulate the calf muscle however travel during this time is not advisable.

• First follow-up in the office.
• Wound or cast inspection for any possible complications or irritable areas +- adjustment of cast.
• Start full weight-bearing in cast with post-operative shoe and crutches initially to pain and swelling.
• Can allow foot to hang down at 3 weeks provided no pain and swelling occurs.

CAST REMOVED

• Cast is removed by my dressing Sister and wound inspected.
• If incision is dry and completely healed, swimming is permitted for rehabilitation purposes taking care to not jump in the pool or apply any unnecessary force.
• Gentle exercise on bicycle without resistance or swimming is permitted preferably guided by physiotherapist.
• At this stage Moon boot is fitted and foot is prevented from inverting or everting and must be used for 6 weeks for any form of walking however patient does not need to sleep with this brace.
• Massage the scar over the ankle 3 times a day with a lubricant.
• Massage should continue for 3 months or until no irritation over the scar is presen.t
• If swelling is problematic you may require the use of a compression sock.
• Start physical therapy under supervision with my protocols and this will focus on scar desensitisation and tendon glide mostly.

• Third followup in rooms at 12 weeks with weight-bearing control x-ray.
• Light nonimpact exercise may commence to pain and swelling.
• Sneakers with a straight medial border and supportive sole.
• Discontinuation of hallux strapping.
• Continued range of motion exercises.

• More vigorous exercise with Biokineticist for the next 8-12 weeks in order to achieve strength within 10% of the unaffected side hence clearing you for return to sport.
• Can discontinue boot at this stage and use a shoe with a supportive sole and a slight heel lift (heel cup) inside the sole of the shoe .
• Flat running on treadmill by 3 months.

• Followup in my consultation rooms.
• Photographs and video taken of range of motion and strength.
• Cutting sports by 4-6 months.
• May require gait analysis and custom orthotics to be made on an individual basis.

• Final followup in my consultation rooms.
• Photographs are taken of range of motion and strength.
• Patient outcome score taken.
• Patient is usually discharged at this stage.