Hallux rigidus – Arthrodesis

Diagnosis:

Hallux rigidus

Surgery:

Arthrodesis (Fusion)

Post operative orders:

Dressings – this is applied in the OR, is to remain intact and kept clean and dry at all times for the first 2 weeks until first review in the office
Elevate: as much as possible
Ice: at least 3 times per day 20 mins on, 20 mins off (ice should not be directly contacting skin or allow dressings to become wet)

Weight bearing Status:

Heel weight bearing as tolerated in the postoperative shoe provided

Driving:

Casts/boots/postoperative shoes can interfere with your ability to drive.
You must be able to safely operate the vehicle including the accelerator, brake and clutch pedals at all times and respond in the event of an emergency.

Exercises:

Knee and ankle ROM exercises are permitted from Day 1

Pain Medication:

Strong pain medication <72 hrs if needed. A script will be provided at the time of surgery. Decrease to simple pain medication e.g. panadol/nurofen No Alcohol or driving whilst taking strong pain medication.

Physiotherapy:

6 weeks: gait retraining, Progressive WB as comfortable and transition to normal shoe if adequate healing, core strengthening and upper limb program.
Generalised stretching/strengthening fitness program and progressive increase in Lower limb weight bearing exercises, stationery bike, swimming.

DVT prophylaxis:

100mg aspirin daily for 2 weeks post surgery OR other anticoagulation as prescribed

Return to Sports:

Expected after transition to a normal shoe has occurred and fitness has improved to allow return to sport. Allow at least 3 months depending on the level of activity.

Swelling:

Expected to decrease when elevated and gradually decrease over time May have persistent swelling for up to 2 years post surgery.

Travel:

It is usually safe to travel short distances on a plane or car 1 week after surgery.
You may experience increased swelling therefore try and keep the limb elevated.
It is more difficult to get around the airport and plane. You will need assistance.

If there is any concern regarding DVT then air travel or long car travel is not advised. In general long haul flights should be avoided for at least 3 months post surgery.

Please take usual precautions for healthy travel such as elevation of the limb, regular movements of the limb and moving around the cabin, stay well hydrated and avoiding alcohol. Additional DVT prophylaxis may be required.
Please discuss any travel plans prior to your surgery

Time off work:

2-3 weeks if office work
3-4 weeks if standing
12 weeks + if heavier manual work

Follow up:

2 weeks: wound review and removal of any sutures 6 weeks: Xray and progress to shoe wear
12 weeks: Xray

Concerns:

Please contact the office (during working hours) or attend your nearest Emergency Department with any concerns e.g. increased leg swelling despite elevation for 30 mins, pain in calf, chest pain, shortness of breath, wound ooze, increasing pain despite pain relief.