Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the dressings dry and intact until the first post operative appointment using taped bags for showering.
• Some bleeding may be seen through the bandage which is normal
• Keep the Velcro shoe on at all times including in bed.
• Weight bear through the heel only (to protect the bone cuts until they heal).
• Two crutches.
• Regular pain medication: Paracetamol every six hours. Regular anti-inflammatories if tolerated. Stronger medication as required.

First post op visit at week 2

• Dressings removed.
• First web space silicon spacer.

Week 3 – 6

• Elevate foot when not walking.
• Wounds can be left uncovered and shower without a bag providing the wound has healed.
• Keep the Velcro shoe and spacer on at all times, including in bed, except when showering.
• Heel weight bearing with crutches as required and for longer distances.
• Pain medication as required.

Second post op visit at week 6

• X-ray.

Week 7 – 12

• Cease Velcro shoe and closed wide shoes can be worn with first web space spacer.
• Begin toe range of motion exercises.
• Activity as tolerated.

3 to 6 months

• Wear normal running shoes.
• Swelling will occur with prolonged standing or walking.
• Begin bicycling.

6 Months to 1 year

• Fashion shoes can be worn.
• 60% of patients attain unrestricted shoe wear.
• Running, tennis.

Smoking

Cease 6 weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for 6 weeks after the operation to reduce the chance of wound and bone healing problems.

Physiotherapy

Will not usually be required. Start stretching the toe joint after six weeks. It will initially be stiff but will loosen up over time.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on the occupation. If working a desk job and transport is available, return to work is possible after two weeks. However, the majority of people will require six weeks off work. If work involves standing or walking for prolonged periods then four to six months may be required.

Both Bunions at One Operation

This option reduces the overall time to recovery but mobility is significantly limited for six weeks. A wheelchair will be required for distances outside the house.

Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the dressings dry and intact until the first post operative appointment using taped bags for showering.
• Some bleeding may be seen through the bandage which is normal
• Keep the Velcro shoe on at all times including in bed.
• Weight bear through the heel only (to protect the bones until they fuse).
• Two crutches.
• Regular pain medication: Paracetamol every six hours. Stronger medication as required. Do not take anti-inflammatories to increase the chances of fusing.

First post op visit at week 2

• Dressings removed.

Week 3 – 6

• Elevate foot when not walking.
• Wounds can be left uncovered and shower without a bag providing the wound has healed.
• Keep the Velcro shoe on at all times, including in bed, except when showering.
• Heel weight bearing with crutches as required and for longer distances.
• Pain medication as required.

Second post op visit at week 6

• X-ray.

Week 7 – 10

• Keep the Velcro shoe on when walking and only walking with a flat foot.
• The shoe does not need to be worn in bed.
• Crutches for longer distances.

Third post op visit at week 10

• X-ray.
• Velcro shoe removed and open/ wide closed shoes worn as tolerated.
• Activity as tolerated.

6 months

• Recommence all activities including sports.
• Normal closed footwear.

Smoking

This surgery is not offered to patients currently smoking or taking nicotine alternatives as the risk of non-union is too high.

Physiotherapy

Not required.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If working a desk job and transport is available, returning to work is possible after two weeks. However, the majority of people will require six weeks off work. If work involves standing or walking for prolonged periods then three months may be required.

High heels

Most patients manage to wear a heel of 2 - 3cm.

Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the dressings dry and intact until the first post operative appointment using taped bags for showering.
• Some bleeding may be seen through the bandage which is normal
• Keep the Velcro shoe on at all times including in bed.
• Weight bear through the heel only (to protect the bones until they heal).
• Two crutches.
• Regular pain medication: Paracetamol every six hours. Regular anti-inflammatories if tolerated. Stronger medication as required.

First post op visit at week 2

• Dressings removed.

Week 3 – 6

• Elevate foot when not walking.
• Wounds can be left uncovered and shower without a bag providing the wound has healed.
• Wean Velcro shoe and wear wide stiff soled shoes when walking.
• Walking when required, not for exercise
• Pain medication as required.
• Crutch for longer distances.

Second post op visit at week 6

• X-ray.

Week 7 – 12

• Activity as tolerated.
• Swelling will occur with prolonged standing or walking.
• Begin bicycling.

6 months

• Recommence all activities including sports.
• Normal closed footwear.

12 months

• Peak recovery.

Smoking

Cease 6 weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for 6 weeks after the operation to reduce the chance of wound and bone healing problems.

Physiotherapy

Not required.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If a desk job and transport is available return to work is possible after two weeks. However, the majority of people will require six weeks off work. If work involves standing or walking for prolonged periods then three months may be required.

Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• The bulky dressing is removed on the first post operative day, leaving the adhesive dressing in place.
• Keep the adhesive dressing dry and intact until the first post operative appointment using taped bags for showering.
• Dorsiflexion exercises are commenced on the first post operative day. Five to ten maximal stretches are performed twice a day.
• Pain medication should be taken half an hour prior to the exercises. Pain medication should be taken regularly: Paracetamol every six hours and Nurofen three times a day providing anti-inflammatories can be taken. Stronger medication as required.
• Some bleeding may be seen through the dressing which is normal.
• The Velcro shoe is worn when weight bearing except when performing the dorsiflexion exercises.
• Weight bear as tolerated in the shoe.
• Crutches are used as required.

First post op visit at week 2

• Dressing removed.

Week 3 – 6

• Elevate foot when not walking.
• Wounds can be left uncovered and shower without a bag providing the wound has healed.
• Loose supportive shoes worn as able.
• Continue dorsiflexion exercises twice a day.
• Pain medication as required.

Second post op visit at week 6

• X-ray.
• Activity as tolerated.
• Normal closed footwear.

3 to 6 months

• Recommence most activities including sports

Smoking

Cease six weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for two weeks after the operation to reduce the chance of wound healing problems.

Physiotherapy

Not required.

Driving

For legal and insurance reasons driving can be resumed at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If a desk job and transport is available return to work is possible after two weeks. If work involves standing or walking for prolonged periods then six weeks may be required.

Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the boot on at all times including in bed until the first post operative appointment. Taped bags for showering.
• Partial weight bear.
• Two crutches.
• Regular pain medication: Paracetamol every six hours in addition to anti-inflammatories if tolerated and stronger medication as required.

First post op visit at week 2

• Dressings removed.

Week 3 - 6

• Wounds can be left uncovered and shower without a bag providing the wound has healed.
• Wear boot at all times, including bed, except for showering and changing.
• Weight bear as pain allows.
• Crutches as required.
• Pain medication as required.

Second post op visit at week 6

• Attend physiotherapy to begin range of motion exercises progressing to joint position (proprioception) retraining.
• Wean boot and wear elasticated ankle brace when mobilising.

3 months

• Graduated return to contact sports wearing ankle brace.

1 year

• Peak recovery.
• Stop wearing ankle brace for sports.

NOTE: If an osteochondral injury is found which requires microfracture treatment to encourage new cartilage then there will be no weight bearing for the first six weeks.

Smoking

Cease 6 weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for 2 weeks after the operation to reduce the chance of wound healing problems.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If working a desk job and transport is available, returning to work is possible after two weeks. If work involves standing or walking for prolonged periods or heavy manual work then three months may be required.

Hospital admission

• One or two nights.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the plaster dry. Taped bags are used for showering.
• Non weight bearing at all times (to protect the bones until they fuse).
• “Knee walker” scooter. Two crutches or a frame for short distances.
• Regular pain medication: Paracetamol every six hours. Stronger medication as required. Do not take anti-inflammatories to increase the chances of fusing.
• Take half an aspirin each day starting the first day after the operation.

First post op visit at week 2

• Dressings and sutures removed.
• Full fiberglass cast applied if swelling sufficiently down.

Week 3 – 6

• Elevate foot when not walking.
• Keep the cast dry. Taped bags are used for showering.
• Non weight bearing at all times.
• Pain medication as required.

Second post op visit at week 6

• X-ray.
• Cast removed and boot reapplied.
• The aspirin is stopped (unless this is a usual medication).

Week 7 – 12

• Partial weight bearing in the boot.
• Boot worn at all times, including in bed, except for showering.

Third post op visit at week 12

• CT scan.

3 to 6 months

• Full weight bearing in normal closed footwear.
• Recommence most activities excluding sports.

12 months

• Swelling resolves.

18 months

• Peak recovery.

Smoking

This surgery is not offered to patients currently smoking or taking nicotine alternatives as the risk of non-union is too high.

Physiotherapy

Not required.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If working a desk job and transport is available, returning to work is possible after two weeks. However, the majority of people will require three months off work.

Hospital admission

• One or two nights.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the plaster dry. Taped bags are used for showering.
• Non weight bearing at all times (to protect the bones until they fuse).
• “Knee walker” scooter. Two crutches or a frame for short distances.
• Regular pain medication: Paracetamol every six hours. Stronger medication as required. Do not take anti-inflammatories to increase the chances of fusing.
• Take half an aspirin each day starting the first day after the operation.

First post op visit at week 2

• Dressings removed.
• Full fiberglass cast applied if swelling sufficiently down.

Week 3 – 6

• Elevate foot when not walking.
• Keep the cast dry. Taped bags are used for showering.
• Non weight bearing at all times.
• Pain medication as required.

Second post op visit at week 6

• X-ray.
• Cast removed and “moon” boot applied.
• The aspirin is stopped (unless this is a usual medication).

Week 7 – 12

• Partial weight bearing in the boot.
• Boot worn at all times (including in bed) except for showering.

Third post op visit at week 12

• CT scan

3 to 6 months

• Full weight bearing in normal, stiff soled closed footwear.
• Recommence most activities excluding sports.

12 months

• Swelling resolves.

18 months

• Peak recovery.

Smoking

This surgery is not offered to patients currently smoking or taking nicotine alternatives as the risk of non-union is too high.

Physiotherapy

Not required.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If working a desk job and transport is available, returning to work is possible after two weeks. However, the majority of people will require three months off work.

Hospital admission

• One or two nights.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the plaster dry. Taped bags are used for showering.
• Non weight bearing at all times (to protect the bones until they fuse).
• “Knee walker” scooter. Two crutches or a frame for short distances.
• Regular pain medication: Paracetamol every six hours. Stronger medication as required. Do not take anti-inflammatories to increase the chances of fusing.
• Take half an aspirin each day starting the first day after the operation.

First post op visit at week 2

• Dressings removed.
• Full fiberglass cast applied if swelling sufficiently down.

Week 3 – 6

• Elevate foot when not walking.
• Keep the cast dry. Taped bags are used for showering.
• Non weight bearing at all times.
• Pain medication as required.

Second post op visit at week 6

• X-ray.
• Cast removed and “moon” boot applied.
• The aspirin is stopped (unless this is a usual medication).

Week 7 – 12

• Partial weight bearing in the boot.
• Boot worn at all times (including in bed) except for showering.

Third post op visit at week 12

• CT scan.

3 to 6 months

• Full weight bearing in normal, stiff soled closed footwear.
• Recommence most activities excluding sports.

12 months

• Swelling resolves.

18 months

• Peak recovery.

Smoking

This surgery is not offered to patients currently smoking or taking nicotine alternatives as the risk of non-union is too high.

Physiotherapy

Not required.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If working a desk job and transport is available, returning to work is possible after two weeks. However, the majority of people will require three months off work.

Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the foot elevated as much as possible above the heart. This will help with pain relief, swelling and wound healing.
• Keep the boot on at all times including in bed until the first post operative appointment. Taped bags for showering.
• Partial weight bear. Two crutches for mobilizing.
• Regular pain medication: Paracetamol every six hours. Regular anti-inflammatories if tolerated. Stronger medication as required.
• Take half an aspirin each day starting the first day after the operation.

First post op visit at week 2

• Dressings removed.

Week 3 – 6

• Wound can be left uncovered and shower without a bag providing the wound has healed.
• Weight bear as tolerated.
• Pain medication as required.
• The aspirin is stopped (unless this is a usual medication).

Second post op visit at week 6

Week 7 – 12

• Incision pain usually resolves.
• Medial arch supports or heel gel pads are needed by 50% of patients.

6 months

• Peak recovery.

Smoking

Cease 6 weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for 2 weeks after the operation to reduce the chance of wound healing problems.

Physiotherapy

Will not usually be required.

Driving

For legal and insurance reasons do not drive for two weeks and then only when feeling comfortable.

Work

This depends on occupation. If working a desk job and transport is available, returning to work is possible after two weeks. However, if work involves standing or walking for prolonged periods then six to 12 weeks may be required.

Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the dressing dry and intact until the first postoperative appointment using taped bags for showering.
• Weight bear as pain allows. One or two crutches for mobilizing if required.
• Regular pain medication: Paracetamol every six hours. Regular anti-inflammatories if tolerated. Stronger medication as required.
• Recommence calf stretching exercises twice a day the day after the procedure.

First post op visit at week 2

• Dressings removed.

Week 3 – 6

• Wound can be left uncovered and shower without a bag providing the wound has healed.
• Weight bear as tolerated.
• Continue calf stretching exercises twice a day.

Second post op visit at week 6

Week 7 – 12

• Plantar fascia pain usually resolved.
• Sporting activity as tolerated.

Smoking

Cease six weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for two weeks after the operation to reduce the chance of wound problems.

Physiotherapy

Not usually be required.

Driving

For legal and insurance reasons if using a manual car or if the right knee is operated on do not drive for two weeks and then only when feeling comfortable. If the car is automatic and the left knee alone is operated on it is possible to return to driving the next day if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If a desk job, return to work is possible after two weeks. However, if work involves standing or walking for prolonged periods then six weeks may be required.

Hospital admission

• Most patients go home the day of surgery.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the boot on at all times including in bed until the first post operative appointment using taped bags for showering.
• Weight bear as pain allows.
• Two crutches.
• Regular pain medication: Paracetamol every six hours. Regular anti-inflammatories if tolerated. Stronger medication as required.

First post op visit at week 2

• Dressing removed.

Week 3 – 6

• Wounds can be left uncovered and shower without a bag providing the wound has healed.
• Boot weaned.
• Full weight bear.

Second post op visit at week 6

• Commence eccentric exercises with physiotherapist.
• Commence swimming and cycling.

3 months

• Commence running.

Smoking

Cease 6 weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for 2 weeks after the operation to reduce the chance of wound healing problems.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If working a desk job and transport is available, returning to work is possible after two weeks. If work involves standing or walking for prolonged periods or heavy manual work then two months may be required.

Hospital admission

• One night.

Week 1 & 2

• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• Keep the boot on at all times. Do not remove it.
• Keep the boot dry. Taped bags are used for showering.
• Non weight bearing at all times to protect the tendon repair.
• Knee walker scooter or two crutches.
• Regular pain medication: Paracetamol every six hours. Regular anti-inflammatories if tolerated. Stronger medication as required.
• Take half an aspirin each day starting the first day after the operation.

First post op visit at week 2

• Absorbable suture ends trimmed.

Week 3 – 6

• Boot worn at all times, including in bed, except for showering and exercises.
• Partial weight bearing in the boot with two crutches.

Second post op visit at week 6

• Boot is weaned.
• The aspirin is stopped (unless this is a usual medication).
• Commence range of motion progressing to strengthening exercises with physiotherapist.
• Commence swimming.

3 months

• Commence cycling and jogging.

12 months

• Peak recovery.

Smoking

Cease 6 weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for 2 weeks after the operation to reduce the chance of wound healing problems.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If a desk job and transport is available return to work is possible after two weeks. If work involves standing or walking for prolonged periods or heavy manual work three months will be required.

Hospital admission

• One or two nights.

Week 1 & 2

• In hospital one or two nights.
• Keep the foot elevated above the heart as much as possible. This will help pain control, swelling and wound healing.
• If you are in a boot keep it on at all times. Do not remove it.
• Keep the boot or plaster dry. Non weight bear at all times.
• “Knee walker” scooter. Two crutches or a frame for short distances.
• Regular pain medication: Paracetamol every six hours. Regular anti-inflammatories if tolerated. Stronger medication as required.
• Take half an aspirin each day starting the first day after the operation.

First post op visit at week 2

• Removal of dressings.
• Change to “moon” boot if plaster was used for first two weeks.

Week 3 – 6

• Boot worn at all times, including in bed, except for showering.
• Non weight bear at all times.

Second post op visit at week 6

• Xray.
• Provided the osteotomy has healed weight bearing is commenced and the boot is weaned over two weeks.
• The aspirin is stopped (unless this is a usual medication).
• Physiotherapy commences with range of motion exercises progressing to strengthening.

6 months

• Swelling resolves.

12 months

• Peak recovery.

Smoking

Cease 6 weeks before surgery to reduce the chance of anaesthetic problems. Do not recommence for 2 weeks after the operation to reduce the chance of wound healing problems.

Driving

For legal and insurance reasons if using a manual car or if the right foot is operated on do not drive for six weeks and then only when feeling comfortable. If the car is automatic and the left foot alone is operated on it is possible to return to driving at two weeks if comfortable and strong pain relief is no longer required.

Work

This depends on occupation. If a desk job and transport is available return to work is possible after two weeks. If work involves standing or walking for prolonged periods or heavy manual work then three months may be required.

This option reduces the overall time to recovery but mobility is significantly limited for six weeks. While you can walk short distances on your heels inside a wheelchair will be required for distances outside your house.