What will the surgery involve?
i. Anaesthetic - usually a general anaesthetic is required; local anaesthetic will be injected around the incision at the end of the operation to reduce the pain. You will have a chance to discuss your anaesthetic with the anaesthetist before the operation.
ii. Incisions - A small incision is made on the back of the calf near the knee
iii. The surgery - The tendon (which attaches muscle to bone) from one of the calf muscles is released, this helps to reduce the tightness of the calf muscle.
iv. Stitches Dissolving sutures will be used to close the skin. The ends of these sutures will be removed at your appointment about two weeks after surgery.
v. Dressings - A dressing will be placed over the wound that should be kept in place until you are seen in the outpatients 2 weeks after surgery. Bandages are placed over this dressing that can be removed 5 days after surgery.
i. Return home - This will usually be the same day.
ii. Pain relief - The local anaesthetic placed around the wound should provide some pain relief, but you will be supplied with pain relieving tablets by the hospital (usually co-codamol and tramadol) these should be taken regularly initially.
You will find it more comfortable to keep your foot up on a chair, if possible above the level of your heart, as much as you can for the first two weeks after surgery. This will help reduce the swelling and therefore also help wound healing.
iii. Walking - You will probably require crutches for a couple of days, but these can be discarded when you feel comfortable to do so. There are no weight bearing restrictions.
iv. Exercises - You should exercise the ankle from the day of surgery
- bend the ankle up to a right angle and beyond slowly 2-3 times per hour for the first two days
increase the frequency with which you do this exercise over the next two weeks
This can be aided by placing a theraband (or a dressing gown cord can be a useful alternative) under the front of the foot to help bring the foot up towards you, gradually bending the ankle.
After 2 weeks you can start performing the full range of Achilles stretching exercises (See: Achilles Stretching Exercises)
iv. Driving - You will not be able to drive until you can walk without crutches confidently. You should usually be able to start driving two weeks after surgery, or earlier if the surgery is on your left leg and you have an automatic car. You should check with your insurance company first.
vi. Follow up - You will be seen in the clinic two weeks after you surgery and the dressing taken down and the suture ends trimmed.
v. Return to work - Approximately:
Office job - 1-2 weeks
Mobile job requiring driving - 3-4 weeks
Manual labour - 4-6 weeks
What are the risks of the operation?
There are a small number of risks of surgery including infection, nerve damage, blood clots, ongoing pain and the need for further surgery (please see General Risks of Foot and Ankle Surgery for further information)