Calcaneus Fracture Repair: 1st Post-op

  1. You may shower tonight, letting soapy water run over you incision(s) and patting them dry with a towel. You should avoid submerging the leg (bath, pool, hot tub, etc.) for at least one week.
  2. You will be strict non-weightbearing in the walking boot.
  3. Use an ace bandage or a thick sock to prevent the boot from rubbing on the incision(s).
  4. You will wear the boot at all times (including sleeping), except for the following:
    • Bathing/showering
    • Exercises
    • In a completely controlled environment, for the purpose of icing
  5. In order to maximize your post-op ankle flexibility, you should come out of the walking boot and preform the following exercises, twice per day:
    • Write the alphabet with your foot. Do two repetitions.
    • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
  6. You will continue to ice and elevate the leg as much as possible. Elevating the leg above the level of the heart will reduce the amount of time required to bring down the swelling.
  7. You should continue taking the blood clot prevention medication (aspirin or equivalent) as prescribed until you are at least 4 weeks post-op.
  8. I would like to see you back in 4 weeks for your next follow-up appointment. We will obtain new x-rays at that time. If there is appropriate evidence of healing, we will likely have you begin progressive weightbearing in the boot.

Ankle Fracture Repair: 2nd Post-op

  1. You will begin progressive weightbearing in the boot and continue this until your next follow-up. Please refer to the separate handout.
  2. You may now remove the boot for sleeping and driving.
  3. You should continue to perform the following exercises to maximize your post-op ankle flexibility. You will do these twice daily, once in the morning and once in the evening:
    • Write the alphabet with your foot. Do two repetitions.
    • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
  4. You will continue to ice and elevate the leg as much as possible. Elevating the leg above the level of the heart will reduce the amount of time required to bring down the swelling.
  5. I would like to see you back in 4 weeks for your next follow-up appointment. We will obtain new x-rays at that time. If there is appropriate evidence of healing, we will likely have you begin transitioning out of the walking boot and into regular shoes.

Ankle Fracture Repair: 1st Post-op

  1. You may shower tonight, letting soapy water run over your incision(s) and patting them dry with a towel. You should avoid submerging the leg (bath, pool, hot tub, etc.) for at least one week.
  2. You will be strict non-weightbearing in the walking boot.
  3. Use an ace bandage or a thick sock to prevent the boot from rubbing on the incision(s).
  4. You will wear the boot at all times (including sleeping), except for the following:
    • Bathing/showering
    • Exercises
    • In a completely controlled environment, for the purpose of icing
  5. In order to maximize your post-op ankle flexibility, you should come out of the walking boot and preform the following exercises, twice per day:
    • Write the alphabet with your foot. Do two repetitions.
    • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
  6. You will continue to ice and elevate the leg as much as possible. Elevating the leg above the level of the heart will reduce the amount of time required to bring down the swelling.
  7. You should continue taking the blood clot prevention medication (aspirin or equivalent) as prescribed until you are at least 4 weeks post-op.
  8. I would like to see you back in 4 weeks for your next follow-up appointment. We will obtain new x-rays at that time. If there is appropriate evidence of healing, we will likely have you begin progressive weightbearing in the boot.

Base of the 5th Metatarsal Fracture

  1. You should remain immobilized in a walking boot/post-op shoe until 4 weeks from the initial injury.
  2. You are allowed to fully weight bear as tolerated in the walking boot/post-op shoe. I would like you to discontinue use of crutches or any other assistive walking devices as quickly as possible.
  3. You may remove the walking boot/post-op shoe whenever seated or lying down, in a safe environment. The walking boot is in place to protect rather than immobilize the fracture.
  4. At 4 weeks post-injury, you may gradually transition from the walking boot/post-op shoe back into stiff-soled, supportive shoes.
  5. I would like you to remain in the supportive shoes for a total of 2 weeks before gradually returning to all types of shoe wear.
  6. While in the walking boot/post-op shoe, I would like you to come out of the walking boot/post-op shoe twice daily to work on the following exercises. You should perform the following exercises once in the morning and once in the evening:
    • You should perform 3 sets of 15 reps of dorsiflexion (up) and eversion (out), but avoid plantarflexion (down) and inversion (in).
    • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
  7. There are no limitations to your activities, as long as they are performed in the walking boot/post-op shoe.
  8. Outside of the walking boot/post-op shoe, you should limit yourself to cycling on a stationary bicycle.
  9. I would like to see you back in 4 weeks for a follow-up appointment. We will obtain new x-rays upon return.
  10. Foot fractures typically take 10-12 weeks to fully heal.

Ankle Sprain Injury

  1. It takes 10-12 weeks to see biological healing of the ligaments.
  2. You should remain immobilized in a walking boot or ankle brace for the first 3 weeks. This should be worn whenever weight bearing.
  3. At 3 weeks post-injury, you may transition from the walking boot back into regular shoes with the assistance of an ankle brace. You should continue to wear the ankle brace for an additional 3 weeks. If you were initially immobilized in an ankle brace, you should remain in the ankle brace until 6 weeks post-injury.
  4. I would like you to come out of the walking boot or ankle brace twice daily to work on the following exercises. You should perform the following exercises once in the morning and once in the evening:
    • You should perform 3 sets of 15 reps of dorsiflexion (up) and eversion (out), but avoid plantarflexion (down) and inversion (in).
    • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold each stretch for a five-count and do five repetitions.
  5. At 6 weeks post-injury, you may discontinue use of the ankle brace with daily use but should continue to use it whenever engaged in higher impact and higher demand activities for the next 3 months.
  6. Physical therapy may begin at 6 weeks post-injury, or earlier if desired. For most patients, physical therapy is not necessary.
  7. I would like to see you back in 4 weeks for a follow-up appointment.