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Possible Problems with Surgery

Two Main Problems

There is a 10% chance that you could have problems from your surgery. Your surgeon will tell you if your surgery has a greater chance of problems. You are the best judge of how your foot or ankle problem affects your life now, so only you can decide whether or not to have surgery.

There are two main problems that can occur after foot and ankle surgery:

1. The effect on you – the ‘hassle factor’

Right after your foot and ankle surgery, you may experience more pain than before the surgery and it may be harder to do things. It will take time to recover from your surgery so you need to be prepared to take time off from your regular activities. For example, you will probably need to take time off from work and you might need someone to help you with cooking, cleaning, or to driving to medical visits. Depending on which foot is being operated on, you might not be able to drive for many weeks after your surgery. All of these things can make having foot surgery a challenge (the ‘hassle’ of having foot surgery).

2. The surgery can cause new problems

The chances are usually low but there is always a chance that the surgery will make worsen your original problem, or cause a new problem. Possible problems you may encounter:

  • The wound heals too slowly.
  • The wound gets infected.
  • The bones heal too slowly.
  • The surgery makes your joints or muscles stiff and harder to move.

These problems usually go away after time and most of them do not affect whether the surgery helps you in the long term.


Some Problems Might Require Another Surgery

You may require additional surgery if:

  • Your bones heal too slowly or do not heal. Smoking (nicotine) can cause the bones to heal too slowly. You must stop smoking six weeks before your surgery. You cannot use nicotine gum or patches either. They have the same effect.
  • You have pain from the screws or pins that were used in the first surgery. Another surgery can be done to take these out once the bone has healed.
  • You have problems with the wound healing that require cleaning in the operating room or a skin graft.
  • You get a bad infection.
  • Your bones heal in the wrong position. The bone might have to be broken again so that it can heal in the right position.
  • You have a joint replacement and the parts of the joint replacement start to come loose or wear away.

Less Common But Very Serious Problems

Possible problems that can affect you for a long time:

  • Pain or numbness caused by nerve damage during the surgery.
  • You could have more pain than expected because the surgery can cause some of your nerves to become over-active. This is called ‘complex regional pain syndrome’.
  • An infection deep in the bone that is hard to treat.
  • The bones not healing after the surgery. (Remember – smoking or nicotine can cause the bones to heal too slowly).
  • Infection in the joint replacement parts. If this happens, you will need another surgery to clean out the joint replacement or replace it with a new one.
  • While rare, these problems might cause you to need an amputation, where part or all of the foot or lower leg is removed by surgery.

Having any surgery or receiving anesthesia can cause problems such as:

  • A heart attack. If you have had heart problems in the past, the risk of a heart attack is higher.
  • A chest infection (pneumonia).
  • A bad reaction to the anesthetic medicine.
  • Blood clots. While not very common after foot and ankle surgery, they can happen. When tissues are damaged, your body tries to heal the damage by forming a collection of sticky blood cells called a blood clot. Sometimes, the clot breaks away and travels in the bloodstream. Blood clots can be a serious problem if they travel into your lungs, resulting in breathing problems.

Tell your surgeon if you have had a deep vein clot in the past. If your surgeon thinks you have a greater chance of getting a blood clot, there is medicine that your surgeon can give you to reduce the chance of blood clots.

While it is not common for a person to die after foot and ankle surgery, it can happen if the person has a heart attack or a blood clot.


Preventing Problems After Surgery

  • Stop smoking at least six weeks before your surgery.
  • Do not start smoking again or use nicotine gum or patches for at least six months after the surgery.
  • Stop taking anti-inflammatory medicine at least 10 days before your surgery. This includes prescription medication such as Celebrex and non-prescription medicines such as ibuprofen (Advil) and naproxen (Aleve).
  • Talk to your doctor about when to stop taking anti-inflammatory medicine.
  • Carefully follow all instructions about how to care for yourself after the surgery.

It Is Your Decision

Most people:

  • Have good results after they recover from their foot and ankle surgery.
  • Have much less pain and get enough strength and movement back to return to their regular daily activities such as walking, driving a car, and activities of daily living (washing, dressing, etc).

It is common to have some pain for about 3 to 4 months after your surgery, sometimes longer.

How well your surgery will work to fix your problem depends on the kind of surgery, how old you are when you have the surgery, and how well you take care of yourself after surgery.

You should only decide to have surgery if you are prepared for the recovery time. You may be quite limited in your physical activities during the recovery period.