The following are post-operative instructions for patients who have undergone a release of the plantar fascia of their foot. Please refer to this reference sheet, which should probably answer most of the questions you might have. If you have further questions that need immediate answering, contact my staff at our office at (970) 879-4612 or 877-404-4612.
Post-Operative Shoe
You will be provided with a postop shoe or fracture boot for your comfort. Use the postop shoe or fracture boot when you are up. You may put weight on your foot and use your crutches as necessary. Elevate the foot at heart level or above. For the first 5-7 days after surgery avoid having the foot dependent. Try and always have the foot elevated, at least up on a chair.
Dressings
You will have a dressing over your hind foot. You may notice some bloody spotting coming through the outer dressing. Although it is unlikely to be significant bleeding, contact us if it continues to become saturated. Otherwise, any small area of spotting will dry and can be ignored until you remove the dressings. Do not remove the dressing unless instructed to do so.
Sutures
The sutures utilized in closing any wounds are not absorbable. They will be removed at approximately 2 or 3 weeks after surgery.
Ice
Ice and elevation will help minimize the pain and swelling after surgery, especially during the first few days. You will be more comfortable in an upright position. You can keep ice packs on the foot more or less continually during the first day or two after surgery without risk of frostbite injury to the underlying skin as long as the original thicker dressing is in place. The initial postoperative wrap involves multiple layers of cotton gauze, therefore insulating the skin surface reasonably well. Once we have removed the original dressing I would recommend ice applications to the heel region for 20 minutes at a time as needed for pain and swelling.
Showers
You must keep the dressing dry and can use the bath with the foot hung out of the tub or sponge bath. If you must use the shower you will need to apply a plastic bag around the foot and tape it at the top. However, it is hard to keep the dressing absolutely dry and some leakage will occur. If the dressing gets a little wet allow it to dry.
Physical Therapy
Normally we will not have any physical therapy after surgery. After surgery, we can do home exercises or physical therapy based on your individual needs and desires. We will discuss your exercises and activity limitations when you are seen in the office.
Office Follow-Up
Please call our office within a few days following surgery to schedule your first follow-up visit for about 7-10 days after surgery. This can vary plus or minus several days depending on your schedule and ours, as we want the wound, swelling, and pain to settle down prior to the first dressing change. We will use the fracture boot or postop shoe for the first couple weeks after surgery. Then we want a shoe or scandal which will be comfortable.
Medications
You will be provided with a prescription for a pain medication when you are ready to leave the hospital. Usually, we will prescribe Hydrocodone or Oxycodone. These are both generic names for two different narcotic pain relievers. If you are aware of a certain pain medication that you have previously had problems with or one that you normally respond favorably to, please inform us so that we can give you the appropriate prescription. You may have the prescription prior to surgery to avoid filling it the day of surgery. Ibuprofen or Aleve is also OK if you can tolerate these over the counter medications. Plain Tylenol is OK if you have no liver disease. Remember, the short acting pain pills often have acetaminophen (Tylenol) in them. The maximum daily dose of Tylenol if you have a normal liver is 3500-4000 mg. If you have a history of nausea with surgery we can prescribe an antinausea medication (Phenergan). Try to take this medication regularly at first and prior to taking the narcotic pain pills to allow it to be most effective. Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. I cannot provide prescription refills after business hours or on weekends.
If you have a history of nausea with surgery we can prescribe an antinausea medication (Phenergan). Try to take this medication regularly at first and prior to taking the narcotic pain pills to allow it to be most effective. Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. I cannot provide prescription refills after business hours or on weekends.
Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. I cannot provide prescription refills after business hours or on weekends.
Complications
Plantar fascia release surgery of the foot is an outpatient surgery and postoperative complications are fortunately quite rare. The incidence of an infection is literally one out of thousands. The onset of symptoms would be approximately 5-7 days following surgery and would consist of a significant increase in pain, swelling, warmth, and redness of the foot, fever, chills or night sweats. There can also be a small incidence of a blood clot developing deep within your leg veins. This would be characterized by a sudden onset of new pain (usually different from your surgical foot pain) or tightness in the foot or calf. This usually begins about 5-7 days from the day of surgery. Sudden onset of shortness of breath may indicate a clot traveling to the lungs. This may occur even if no sign of a clot in the leg is present. The presence or absence of a blood clot can usually be determined by a simple non-invasive ultrasound test at the hospital or some doctor’s offices. Tests to determine if a lung clot is present are done at the hospital. Contact our office for any concerns at 970-879-4612 or 877-404-4612. 9/2011
Bryan Bomberg, MD
9/11