What is foot and ankle surgery?
Foot and ankle surgery is a specialised branch of orthopaedic surgery that focuses on the diagnosis and treatment of conditions affecting the lower extremities. This field encompasses a wide range of surgical procedures aimed at addressing issues such as fractures, deformities, arthritis, ligament and tendon injuries, and other disorders affecting the foot and ankle. Surgeons in this discipline employ both traditional and advanced surgical techniques to alleviate pain, improve function, and restore mobility in patients with various foot and ankle problems. Common procedures include bunion surgery, ankle arthroscopy, Achilles tendon repair, and joint replacements. The goal of foot and ankle surgery is to enhance the overall quality of life for individuals experiencing discomfort or impairment due to conditions affecting these crucial weight-bearing structures.
Is foot or ankle surgery painful?
This question is frequently asked in clinics, understandably. With the use of modern techniques and the so-called “Regional anaesthetic block”, we are able to better control post-operative pain. This technique injects local anaesthetic into specific areas to numb the nerves of the foot. It can be used as a complement to General and spinal anaesthesia or on its own. The studies have proved that it can significantly reduce pain postoperatively and in turn minimise the intake of strong pain medication, providing overall a much better patient experience.
Thanks to these techniques, the pain experienced following surgery of the foot and ankle is about 1 or 2 on a scale of 10 (Being 0 no pain at all and 10 the worst imaginable pain). Pain levels are more than halved compared to the classic anaesthetic techniques where these are reported between 3 and 5 for the same type of surgery.
The picture above shows some of the instruments used in a “Regional anaesthetic block” which in some cases can be done using ultrasound to guide the needle into the correct targeted nerves in the leg. The whole procedure can be done after being put to sleep so the patient is comfortable throughout, unaware of any injections.
How soon after foot, toe or ankle surgery can I drive?
Driving is not permitted if you are in a cast or wearing an orthopaedic boot. As an orthopaedic study highlighted “boots are not made for driving”1. The type of surgery will directly affect the return to driving as different operations will require different immobilisation methods and times. Equally important is the operated side and whether you are driving an automatic or a manual car.
For instance, after bunion surgery to the left foot the patient is normally fit to drive an automatic car after 2 weeks from surgery; surgery to the right foot or a manual car would generally require 6-8 weeks instead for the same operation.
In the end it comes down to safety on the road. One should only go back to driving when it is safe to do so, which in short occurs when the driver is able to perform an emergency stop. One way of assessing you are capable of this is with the car turned off, and try to stomp the foot down on the brakes. If this can be done firmly and pain free, then it is considered that one is fit to drive safely. A study2 investigated this change in time needed to perform an emergency stop following different types of lower limb surgery and concluded that braking function returns to normal at:
- 4 weeks after knee arthroscopy
- 9 weeks after surgical fixation of an ankle fracture
Also bear in mind that some pain medication used after surgery can affect your reaction time and ability to drive.
Going back to driving too soon will potentially delay and impair the healing process, but more importantly it may put yourself or others on the road at risk.
The DVLA has issued a guidance3 on assessing fitness to driving after medical conditions and surgery. If recovery time is likely to persist for 3 months or longer, drivers need to notify the DVLA of surgical recovery, but it is not required if it is less than 3 months. Furthermore, drivers must ensure they remain covered by insurance to drive after surgery.
Ultimately it is the responsibility of the driver to ensure that they are in control of the vehicle under any circumstances and when to resume driving following surgery. Always ask your surgeon to help you in every particular case to establish the right time to do so.
Recognising the signs and symptoms of these conditions is crucial for seeking timely medical attention. Mr Francesc Malagelada is dedicated to diagnosing and treating various foot and ankle conditions, providing personalised treatment plans to address your specific needs and help you get back on your feet comfortably. Contact us and book an appointment today!
Keep in mind that our blog is also a great place if you’d like to stay updated on the latest orthopaedic news.
This article is for information purposes only and is not a substitute for professional medical advice. Consult your physician for personalised guidance. In case of a medical emergency, contact your doctor or emergency services.
References:
1. Symes MJ, Escudero M, Abdulla I, Veljkovic A, Paquette S, Younger AS. Boots are not made for driving: a cautionary case report about the dangers of driving in a CAM walker boot and literature review. Foot Ankle Spec. August 6, 2018.
2. Marecek GS, Schafer MF. Driving after orthopaedic surgery. J Am Acad Orthop Surg. 2013;21(11):696-706.