Limb Lengthening
1. DIET
Begin with clear liquids and light foods (jellos, soups, etc.)
Progress to your normal diet if you are not nauseated
2. WOUND CARE
Maintain your operative dressing, loosen bandage if swelling of the foot or ankle occurs.
It is normal for the knee and tibia to bleed and swell following surgery – if blood soaks onto the bandage, do not become alarmed – reinforce with additional dressing.
Surgical dressing may be removed 1 week after surgery at your first post-operative appointment.
To avoid infection, keep surgical incisions clean and dry – you may shower and wet your incisions/external fixator once dressings are removed
NO immersion of operative leg (i.e. bath) until limb lengthening process is complete
3. MEDICATIONS
Do not drive a car or operate machinery while taking the narcotic medication*, and increase the time intervals between narcotic pain medication usage
A surgical block was used during surgery– this will wear off within 8-12 hours.
Most patients will require narcotic pain medication for a short period of time.
Primary Medication Percocet (5 mg Oxycodone/325 mg of Acetaminophen)
Take 1 tablet every 4 – 6 hours as needed (If pain is severe may take 2 tablets)
Max of 12 pills per day
Plan on using it for 2 to 5 days, depending on level of pain
Take additional Ibuprofen (Advil) or Naproxen (Aleve) as needed.
Common side effects of the pain medication are nausea, drowsiness, and constipation – to decrease the side effects, take medication with food.
If constipation occurs, consider taking an over-the-counter laxative such as prune juice, Senekot, Colace (or Periocolase), or Miralax.
If you are having problems with nausea and vomiting, contact the office to possibly have your medication changed
For nausea, take prescribed Zofran / Phenergan
4. ACTIVITY
Begin exercises 24 hours after surgery (straight leg raises, quad sets, heel slides and ankle pumps) unless otherwise instructed.
Discomfort and knee stiffness is normal for a few days following surgery – it is safe and, in fact preferable to bend your knee (unless otherwise instructed by physician).
Complete exercises 3-4 times daily until your first postoperative visit – your motion goals are to have complete extension (straightening) and 120 degrees of flexion (bending) of your knee at your first postoperative visit unless otherwise instructed.
Do ankle pumps continuously throughout the day to reduce the possibility of a blood clot in your calf (extremely uncommon).
Formal physical therapy (PT) will begin immediately after surgery so that you may ambulate in the hospital or surgery center.
You will be immediately weight bearing as tolerated with walker or crutches
5. ICE THERAPY and ELEVATION
Begin immediately after surgery.
Use ice packs every 2 hours for 20 minutes daily until your first post-operative visit – remember to keep leg elevated to level of chest while icing. It may be difficult to place ice directly on your limb if you have an external fixator. If this is the case rely more heavily on limb elevation
6. EMERGENCIES**
Contact Dr. Aran or the office at 305 667 8686 if any of the following are present:
Painful swelling or numbness
Unrelenting pain
Fever (over 101° - it is normal to have a low grade fever for the first day or two following surgery) or chills
Redness around incisions
Color change in the limb
Continuous drainage or bleeding from incision (a small amount of drainage is expected)
Difficulty breathing
Excessive nausea/vomiting
7. FOLLOW UP CARE/QUESTIONS
A member of Dr. Aran’s team will call you on your first day after surgery to address any questions or concerns. If you have not been contacted within 48 hours of surgery, please call the office at 305-667-8686. • If you do not already have a postoperative appointment scheduled, please contact the office during normal office hours and ask for appointment scheduling.