The first 48 hours
After a short stay in the theatre recovery area you will return to the ward. When you come back from the operation your ankle will usually be rested in a plaster splint to keep the ankle immobilised and it will still require elevation for a further 48 hours. In some circumstances the plaster splint may be removed earlier to allow early mobilisation.
You may have a ‘drip’ in your arm to ensure that you get plenty of fluids because you are unable to take any by mouth for a short time after the operation. Once you are able to eat and drink normally this ‘drip’ will be removed. This is usually on the first day after your operation.
Once the swelling has subsided you will be put into a below knee plaster. You will have stitches or clips in the wound and these are usually removed at your first outpatient appointment.
Many patients worry about how painful ankle fixation will be and all staff understand this. It is usual to experience some discomfort and the staff will give you painkillers when you need them to help keep you comfortable. Everyone feels differently and it is important that you tell the nurses if you are in pain.
Getting up and about
You will remain in bed with your leg elevated for 48 hours after surgery following this, the splint will be removed. Your surgeon will then decide when you can begin to mobilise.
You will be taught appropriate exercises by the physiotherapist.
The physiotherapists and nurses will help you out of bed and supervise your mobility, walking aids will be required. You will be supervised until you are safe.
Once the swelling has reduced a plaster is applied to protect you from putting any weight on the ankle. You will usually be non-weight bearing for 3 – 6 weeks depending on your x-rays. Once your x-rays are satisfactory a walking heel will be applied to your plaster cast.
What problems can occur?
No operation is without the risk of complications. Your surgeon and therapist will explain any particular risks/complications of you operation before surgery.
Swelling is common after surgery and might be treated by elevation.
Is the operation always successful?
The surgeon’s expectations of your operation will be discussed before surgery (usually when initially seen in outpatients) so that you understand the likely result, and the risks/benefits of the proposed operation. This information must be taken into account when you make the decision to undergo surgery.
Your discharge
Your length of stay in hospital will vary depending on the swelling at the operation site and on your individual circumstances. Once you are moving around safely on your own, you will be discharged home as soon as suitable arrangements can be made.
Planning for going home begins as soon as you arrive in hospital. If you have any fears or concerns regarding your discharge please discuss these with your named nurse.
Your named nurse will ask you and your carers about your social circumstances, this is just to ensure that you will be able to manage certain tasks when you go home such as washing, dressing and cooking.
If your named nurse feels you and your carer will require extra support she will discuss this with you and with your permission will arrange for you to talk with the hospital social worker and Occupational Therapist.
If you live in the Newcastle area then you will be assessed by the Orthopaedic Discharge Team (ODT) who will assess your suitability for the scheme, which provides a two week supported discharge with nurse, physiotherapy and Occupational Therapy involvement.
Transport home
Please discuss your transport arrangements home with your named nurse before your day of discharge. It is possible in some instances to organise hospital transport, if required.
The day of discharge
On the day of your discharge your named nurse will give you some things to take home, these will include:
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A letter for your GP (in some instances this will be posted) This should be handed in to your GP by either a relative or friend on the next working day following your discharge.
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Medication Any medication you have bought into hospital will be returned to you. You will also be given a 7-day supply of any new medications. The nurse will advise you on how and when to take these.
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Outpatient Clinic Appointment You will be given an appointment to be reviewed in clinic. If transport is required this can be arranged by contacting your GP providing a weeks notice where possible. If for any reason you are unable to attend your appointment please contact the outpatient department to rearrange the appointment.
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Care Plan If you have a care package arranged you will receive a copy of the care plan from the Social Worker before your discharge home. This is for your own information.
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Discharge Record This provides details about your stay and is for your own information.
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Plaster Instruction (if required) The nursing staff will provide you with instructions on how to care for your plaster once you are at home.
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Mobility aids It is important that you have your walking aids and any other equipment that you require.
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Patient information Please take home any written information given to you during your stay and please do not hesitate to use the contact numbers if you require any further advice.
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Valuables Please ensure you have all your valuables with you.
General advice after discharge
You should anticipate at least a 12-week period of convalescence at home before you are able to resume your normal activities
Exercises Your physio will explain the exercise you should do following your discharge and, if appropriate, the ward physiotherapist will arrange an outpatient physiotherapy appointment. When sitting keep your leg elevated on a chair or stool. If possible your foot should be slightly higher than your hip as this will help reduce any swelling.
Work How soon you are able to return to work will depend on the type of job you do. You should discuss this with your consultant when you see him in the outpatient department.
Wound Care Keep your wound and plaster dry. Your stitches or clips will be removed when you attend the Outpatient clinic. You should not bathe whilst you have a plaster in situ, however you may shower if your plaster is covered with a waterproof bag.
Pain Take your painkillers as prescribed. Do not take more than the stated dose. Contact your doctor if you have any pain or swelling in your calf, if you have any chest pain or if you experience increasing ankle pain.
Cars and Driving It is inadvisable to drive while wearing a cast, splint or restrictive bandage. Always check with your insurance company before starting to drive again. It is not the responsibility of your consultant to make this decision. He will advise when he feels driving will cause you no harm.
Return of equipment
Please return all walking aids to the Physiotherapy Department at the hospital in which you stayed, when they are no longer required. All other equipment should be returned to the loan equipment store it came from, ring them and they will collect it (the numbers are outlined at the back).
Follow up
You will be followed up as an outpatient at regular intervals after your discharge from hospital. Please use this opportunity to ask questions and discuss any concerns you may have. You are also welcome to call the ward for advice, following your discharge from hospital.
