Post Operative Instructions

Achilles Tendon Repair

You have undergone repair of your Achilles tendon, the structure that connects the calf muscle to the heel. The repair is performed by making a small incision, evacuating the hematoma (blood that forms around the torn tendon edges), and repairing the torn tendon edges together using suture material.

CAST/SPLINT

Your leg has been immobilized with a compressive dressing reinforced by a posterior splint or cast. Although a bit cumbersome, the splint/cast provides comfort by immobilizing the site of surgery.

SWELLING/BRUISING

Swelling can be controlled by elevating your leg. Try to keep your leg up elevated upon a few pillows for the first 48 hours. The goal is for the leg to be above the level of your heart. Swelling is further minimized by use of ice or cold therapy directly over the site of surgery. Alternatives include use of a bag of ice or frozen vegetables (such as peas/corn) beneath your ankle. Even though you are in a splint or cast, temperature at the surgical site will be decreased. Some degree of swelling of your foot and toes is normal. Because bleeding from the surgical site cannot escape, it typically will travel under the skin to the most "dependent" part of the extremity. Do not be alarmed then by the site of an evolving bruising of the foot and/or toes, which can increase over the first few weeks until ultimately resolving.

DRESSING/WOUNDCARE/BATHING

Your dressing/splint/cast will remain in place until seen in the office. It will be removed or changed at follow-up in the office, at which time a cast is typically applied. You may bathe or shower, but should keep the dressing/splint/cast dry, through use of a plastic bag (such as a clean garbage bag) as a cover. Secure it with tape above the dressing/splint to prevent getting it wet. If you are going to take a shower, you should use a plastic chair or some other means of sitting, both for balance and to avoid placing any weight on your leg. As an alternative you may want to try a bath and keep your leg hanging over the side of the tub.

ACTIVITY

For the first week try to minimize how much you're up and about. The more your leg is "dependent" the greater degree of discomfort, including pain and a throbbing sensation in your leg. Do not weight bear (put weight on your leg).

PAIN MEDICATION

Vicodin® (Hydrocodone) or Percocet® (Oxycodone) narcotic pain killers, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

Pain Medication Tips:

  • Do not drive while taking pain medications.
  • Do not drink alcoholic beverages while taking pain medications.
  • Pain medication should be taken with food as this will help prevent any stomach upset.
  • Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible.
  • To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.

DVT (BLOOD CLOT) PRECAUTIONS

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

FOLLOW-UP

You should be scheduled for a post-op appointment in about 10 - 14 days following surgery, at which time your cast/splint will be removed and we will review your post-operative program and answer any of your questions.

Your post-operative appointment is scheduled on: _______________________________________________.

If you need to verify or change your post-op appointment, please call 703-277-BONE (2663).

PHYSICAL THERAPY

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

IN CASE OF EMERGENCY

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:

  • Fever greater then 101.5 degrees F
  • Numbness, loss of color or coolness in hand
  • Severe pain unresponsive to narcotic medication
  • Excessive bleeding or vomiting
  • Difficulty breathing or shortness of breath – Call 911