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Foot & Ankle Problems Message Board


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[QUOTE=roz5;5335567]I am scheduled to have a second surgery on my foot the day after Christmas. Exactly one year ago, I had joint fusion surgery for an arthritic joint in my foot (navicular/cuneiform). That surgeon assured me at every appointment this past year that the fusion was successful. Yet, in April, the pain began to worsen. I finally went for a second opinion, and this orthopedic surgeon told me that the joint did NOT fuse!! And so, he is going to do surgery in 2 days. The first surgeon used an external fixator (no internal hardware) and made me walk on it after 2 weeks! The ortho surgeon is using internal plate and screw, and will put me in a hard cast; non weight-bearing for 6 weeks. I have never had a cast before and was wondering: 1. Will the cast allow for swelling in the early stages of recovery? and 2. The cast must obviously be removed when the stitches have to come out? I assume the cast will be cut off and a new one put on? Any advice or information you can share would be greatly appreciate! This is my 6th foot surgery (previously had 3 plantar fascia surgeries; bunion surgery; and a failed joint fusion). Thank you everyone![/QUOTE]

Hello! First they put you in a splint that has cast-like features, with lots of padding to allow for swelling and some fiberglass material on each side to keep the foot in non-motion and for protection of your foot. You can google a Jones compression cast for an example. After 10-15 days, they will remove the splint, check for swelling, and most likely remove the stitches and add steri strips to protect the incisions. The steri strips may stay in place 4-10 weeks. Initially your foot is more swollen, and the cast feels tight when you change from elevation and ice down to a sitting position. When the blood rushes to your foot, your foot may swell some and the cast may feel tighter.

Later, perhaps after 3-4 weeks, the swelling will come down and your cast may become loose. If the cast is hurting or rubbing on your foot and causing it pain, then it is time for a new cast. I had my cast changed six times in a nine week period, which I know sounds excessive. My cast was at 88* instead of 90*, so it was changed three times before they got it right. then it was too tight and then too loose. When it was finally just right, my foot had fused, happily, and I went into a CAM walker (often called a boot) at 9.2 weeks.

I've been in a CAM boot for three months, which is much longer than I expected, as I have had too much pain when transitioning from PWB to FWB. I am finally doing much better, walking short distances in my house only. I will soon get a new Richie brace to transition to shoes, and then eventually transition out of the Richie brace as well. Slow steps, but I'll get there.

Best wishes for a successful surgery and a good recovery.

K





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