In the post-operative period, in the first forty-eight hours, patients should restrict movement by only going to the toilet and elevate the leg on pillows as much as possible. Between 2–14 days, patients should aim to move around taking gentle weight through a post-operative shoe which is to be used only when walking. During this period the leg should be elevated regularly for at least thirty minutes, three times a day at 11.00 a.m, 2.00p.m and again at 6.00p.m. At night-time it is advisable to place a pillow under the mattress to keep the leg slightly elevated to the body position.
A follow-up appointment will be made for a change of dressing and to make sure the wound has healed; at this stage self-mobilisation exercises of the big toe will also be shown to the patient. A referral for gentle physiotherapy will also be made. Patients should be able to come out of the protective post-operative shoe and go into a well-fitting, but loose-fitting shoe, such as trainers.
Between 4–6 weeks, the foot gradually returns to normal with a reduction in swelling and patients should be able to walk reasonable distances, but not do any running, jumping or any other activities which put lot of impact on the foot. Once the wound has healed, patients can start swimming by about three weeks after the operation. The earliest physical activity patients can do around at 4–6 weeks, is cycling. At about three months it is expected that the majority of patients to be able to walk normally, wear loose fitting shoes and gradually resume all their activities.