Foot and Ankle Surgery: Considerations for the Geriatric Patient

Daniel K. Lee; Gerit D. Mulder


J Am Board Fam Med. 2009;22(3):316-324. 

In This Article

Postoperative Considerations

The majority of foot and ankle surgery is performed in an outpatient setting. However, this should not minimize strict perioperative management. Emphasis on mobility and function and aggressive rehabilitation for deep venous thrombosis prophylaxis is important.[22,35–37] Time for foot and ankle surgery rehabilitation has previously been documented as 1½ to 2 times that of a young patient, with precautions for a short-leg non-weight-bearing cast, contralateral limb injury, and/or potential for over use and falling.[11] With the advent of advanced surgical techniques and ambulatory devices, these practices are changing. Early ambulation is recommended to decrease adverse effects of anesthesia after surgery while minimizing the risks of cardiopulmonary complications commonly associated with surgery and anesthesia. Pain management may be accomplished with regional blocks and continuous local infusion systems, which have eliminated or minimized the intake of postoperative pain medications and narcotics.[12,13] Consideration of all the factors previously discussed allow for selection of the appropriate postoperative setting to assist with rapid recovery and a return to the patient's previous lifestyle.