Expected Post Operative Course of a Talonavicular Fusion
For the duration of time that the patient is non weight bearing there is some risk of a vein clot or D.V.T. (Deep Vein Thrombosis) forming in one or both legs. Therefore for some patients a medication is used to "thin" the blood. For the time the patient is in hospital a small injection is given under the skin once or twice a day in order to achieve this. After discharge an oral medication is used for this purpose. The medication may be in the form of Aspirin or a stronger medication (Warfarin). Usually a medical practitioner is used to manage this therapy. This therapy is combined with use of a compression stocking on the non operative leg to prevent the formation of vein clots.
The patient is discharged from hospital between 1 to 2 days after surgery
Between 3 and 7 days the cast and dressing are removed and the wound is checked to see that healing is progressing as expected. A new dressing is applied and the fibreglass cast is bi-valved and made into a removable splint. It is very important to the success of the surgery that no weight be placed on the operative foot until the Podiatrist instructs the patient to do so. This is between 8 to 12 weeks after surgery.
At 3 weeks after surgery the patient is able to get the foot wet as well as start rehabilitative exercises in preparation for walking. At this time, a below knee compression stocking is utilised to control swelling. This stocking is used for 6 to 12 months after surgery.
A series of post operative Xrays are taken to check that bone healing is occurring. This is usually at 4 weeks, 8 weeks, 12 weeks and 12 months. A return to walking occurs via a slow and progressive program. A new orthotic device is prepared before the patient starts to walk and is fabricated ready for a return to walking.
A special brace and crutches are used for walking. After 2 weeks the crutches are not usually needed. The brace is then used for a further 2 to 4 weeks. A return to normal footwear occurs with lace ups at about 12 to 16 weeks and all forms of footwear at 4 to 6 months. The foot and ankle appear "different" compared to the other side for 12 to 18 months.