Acute Achilles Repair

Post-Operative Instructions for Acute Achilles Repair

Wound Care

  • You will have a splint to keep the ankle immobilized. Please keep this clean, dry, and intact until your follow up appointment.
  • To keep the splint dry you may take a sponge bath, or shower with a waterproof bag over the leg (use rubber bands or tape at the top to prevent leaks).
  • Occasionally there is excessive bloody drainage that soaks through the splint. Please call the office to determine if a new splint is needed.

Activity
You will be nonweightbearing on the operative leg. Crutches will be necessary to support your weight during this time; these will be provided at time of surgery. Some patients may benefit from a knee scooter for extra support; this is available at medical supply stores and requires an MD prescription.

Outpatient Physical Therapy is usually not needed until 6 weeks after surgery. Until then you will have restrictions on the amount of dorsiflexion (up-motion at the ankle) you can perform.

Controlling your pain and inflammation

Some pain, swelling, and bruising is expected after surgery. It is usually most severe for the first 2-3 days. The following strategies are especially important during this time. Try to anticipate an increase in pain when the nerve block wears off, usually within 12-24 hours.

  • Rest – Take things easy for the first few days, try to rest and avoid prolonged crutch walking or standing.
  • Ice – Apply an ice pack to your operative leg to reduce pain and inflammation. This can be done above the splint, or on top of the splint (this will require icing for longer periods). Take care not to put ice directly on the skin or splint. You should continue this for the first 2-3 days or longer if you still have pain and swelling.
  • Elevate – Put pillows under your operative leg and lie flat so that your ankle is above your heart. This will help to drain fluid from the leg and reduce swelling. Try to do this as much as possible for the first 3 days.
  • Medication – You may have received a prescription for narcotic and/or anti-inflammatory medication. Please take them as instructed. The medication is most helpful if taken 30-45 minutes prior to any planned activity.

Follow up appointment
If an appointment has not already been scheduled, please call the office at 206-633-8100 and schedule an appointment for 10-14 days after your surgery. During this visit we will remove the splint to examine the incisions, and remove any sutures if necessary.

Returning to work
You may return to work when it is safe to do so within the above activity restrictions. Please note that your employer may prohibit narcotics while at work. Please continue to ice, elevate, and take frequent rest breaks while at work. A doctor’s note or Duty Status form can be provided during your follow up appointment.

Driving
For those who had surgery on the LEFT ankle, you may drive an automatic transmission once it is comfortable to do so and you are no longer taking narcotic medication. For the RIGHT ankle, or those with a manual transmission, you will be unable to drive for 4-6 weeks. Usually this will coincide with your 2nd follow up appointment.

  • Narcotics (oxycodone, hydrocodone, etc.)- prescription medication for reducing pain. They may cause drowsiness, confusion, nausea, and constipation. To avoid constipation, increase your intake of fiber, fruits, and vegetables, and stay hydrated. Over the counter laxatives can be taken to treat constipation while on narcotics; please see separate handout or ask your pharmacist.
  • Anti-inflammatories (Ibuprofen, Naproxen, etc.) – available over-the-counter to reduce pain and inflammation. Avoid them if you have diagnosed kidney disease or active ulcers. This medication can cause upset stomach; please take them with food. To treat an upset stomach, take an over-the-counter antacid or proton-pump inhibitor (ask your pharmacist for assistance).
  • Acetaminophen (Tylenol) – Used to reduce pain and decrease fever. Avoid taking this medication if you have liver disease. Taking more than the recommended dose can lead to liver damage. For an adult, it is safe to take up to
    4,000 milligrams each day (24 hour period). Some prescription narcotics already have acetaminophen in them.
  • Antihistamines (e.g., benadryl, hydroxyzine) – Used to treat some side effects from narcotic use, such as itching and nausea. Can cause drowsiness and confusion.
  • Antiplatelet drugs (aspirin, etc.) – medication used to thin the blood and reduce the risk of blood clots. Aspirin may cause upset stomach; please take it with food. If you continue to have upset stomach, you can try an over-the-counter antacid or proton-pump inhibitor (ask your pharmacist for assistance).

Please call the office if you have the following:

– Fever above 101°, pus draining from wound, worsening redness or rash
– Difficulty breathing
– Continuous bleeding from wound (see “wound care” above)
– Numbness or weakness that is not improving after the nerve block has worn off (1-2 days)
– Intolerable pain when the above strategies for pain control have failed.

For questions or concerns not addressed on this form, please call our office at 206-633-8100. The clinic is closed during the evenings, weekends, and holidays. For urgent matters after hours, an on call provider can be reached at the above number.