Bunion Surgery Rehabilitation Guide

1. 01

   Immediate Post-Operative Care

   First 24-48 hours following surgery

   Weight-Bearing Instructions

   You will be provided with a post-operative shoe for your comfort. Use the post-operative shoe when you are up. You may put weight on the heel of the shoe and use your crutches as necessary.

   Important: Avoid putting weight on the forefoot or toes during the initial healing phase.

   Elevation Protocol

   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.

2. 02

   Wound Care Management

   Proper dressing care and monitoring

   Dressing Maintenance

   You will have a bulky dressing over your 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.

   Suture Care

   The sutures utilized in closing any wounds are not absorbable. They will be removed at approximately 10 to 14 days after surgery.

3. 03

   Pain Management & Ice Therapy

   Effective pain control and swelling reduction

   Ice Application Protocol

   Phase 1: First Few Days

   You can keep ice packs on the foot for 30 minutes every 1-2 hours during the first few days without risk of frostbite injury to the underlying skin as long as the original dressings are in place. The initial post-operative wrap involves multiple layers of cotton gauze and padding, therefore insulating the skin surface reasonably well.

   Phase 2: After Dressing Change

   Once you have removed the original dressing I would recommend ice applications to the large toe region for only 20 minutes at a time every 2 hours as needed for pain and swelling.

4. 04

   Hygiene Guidelines

   Keeping the surgical site clean and dry

   Recommended: Bathing

   You must keep the dressing dry and can use the bath with the foot hung out of the tub or sponge bath.

   Alternative: Showering

   If you must use the shower you will need to apply a plastic bag around the foot and tape it at the top. There are excellent cast protector products available locally at pharmacies or online from Amazon (Duro-Med). However, it is hard to keep the dressing absolutely dry and some leakage may occur. If the dressing gets a little wet allow it to dry.

5. 05

   Physical Therapy

   Recovery exercises and activity timeline

   Therapy Timeline

   Normally we will not have any physical therapy until 6-8 weeks after surgery. At that time we can do home exercises or physical therapy based on your individual needs and desires.

   Note: We will discuss your exercises and activity limitations when you are seen in the office.

6. 06

   Office Follow-up Schedule

   Important appointment timeline and care plan

   First Follow-up Visit

   Please call our office within a few days following surgery to schedule your first follow-up visit for about 7 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.

   Weekly Dressing Changes

   We will then do weekly dressing changes to adjust the position of the great toe as needed until 4 weeks after surgery. At that time we will start using a silicone toe spacer.

   Footwear Transition

   We will use the postop shoe for the first 4-6 weeks after surgery. Then we want a shoe or sandal which will not put pressure on the great toe.

7. 07

   Potential Complications

   Understanding risks and protective measures

   General Information

   Bunion foot surgery 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.

   Blood Clot Prevention

   If you have had a previous blood clot, use estrogen, or have a family history of blood clots in the legs, arms or lungs you should probably be protected with TED hose and a blood thinner. If we recommended aspirin for blood clot protection you should use a baby aspirin twice a day for 2 weeks or as long as the leg or arm is immobilized.

   Diagnosis: The presence or absence of a clot can usually be determined by a simple non-invasive ultrasound test at the hospital.

8. 08

   Warning Signs - Contact Immediately

   Symptoms requiring immediate medical attention

   Infection Signs

   • Significant increase in pain, swelling, warmth, and redness of the extremity
   • Fever, chills, or night sweats
   • Small superficial infection or irritation at skin incisions

   Blood Clot Signs

   • Sudden onset of new pain (usually different from your surgical pain)
   • Tightness in the upper arm or more commonly the leg
   • Usually begins about 5-7 days from the day of surgery

Please note: this guide is general information from FootArk’s rehabilitation guidance. Your surgeon’s instructions for your own operation always come first.