SURGICAL GUIDE

Learn about requirements, instructions, and what to expect for your upcoming surgery

Custom-Molded Orthotics

Custom-molded orthotics are specially-made devices designed to support and comfort your feet. Prescription orthotics are crafted by our lab for you and no one else. Only a prescription orthotic can accommodate your unique foot structuresomething over-the-counter orthotics cannot do.

Our custom devices can help with many lower extremity conditions, including:

In-Office Digital X-Ray

At Modern Foot & Ankle we have a state-of-the-art podiatric digital X-ray unit. This means convenience and lowered expenses for our patients.  Instead of X-ray film, digital radiography uses a digital-image capture device. This gives the advantages of immediate image preview and availability. Our doctor will have access to your radiology results as soon as the click of a button.

Restorative Therapy

Soft tissue injuries are caused by either a trauma or overuse. Micro-tears in the tissue form and become inflammed. Inflamed tissue often turns into scar tissue which can inhibit the healing process. Restorative therapy uses a human amniotic membrane graft supplied in an easy-to-use in-office injection. This injection contains natural growth factors that reduce inflammation, reduce scar tissue, and enhance healing of micro-tears in soft tissue.

You may benefit from restorative therapy if you have had an injury that is not relieved by conservative measures including ice, rest, and anti-inflammatories. Our restorative therapy is introduced into the injured tissue via an injection in our office. Recovery is easier than surgery and allows for immediate weight-bearing in a CAM boot for 1-2 weeks.

TOPAZ Microdebrider

TOPAZ microdebrider is a minimally invasive treatment for tendon pathologies involving the foot and ankle. A TOPAZ device is a wand that is applied to target tissues through a pinhole sized incision. When activated, the TOPAZ wand emits radio-frequency energy to the tissue. This radio-frequency energy removes devitalized (dead) tissue with pinpoint accuracy, ensuring normal tissue remains untouched. The removal of the devitalized, injured tissue promotes a suitable environment for healing. TOPAZ microdebrider is a minimally invasive alternative to other procedures to fix tendon related injuries and pathologies. This means a quicker recovery and return to activity. If you are an active patient with an overuse injury of the foot or ankle, TOPAZ may be for you.

Platelet-Rich Plasma (PRP) Injections

Platelet Rich Plasma (PRP) Injections are an innovative procedure where blood is drawn from the patient and placed in a centrifuge to yield a high concentration of the body’s platelets.  Platelets contain many growth factors that are responsible for helping heal complex injuries. This procedure can be done in the office or in an outpatient surgical center. Patients are then placed in a CAM walker for approximately two weeks to immobilize the area and promote healing.

Surgical Guide

Pre-Op Care

Day of Surgery

Post-Op Care

Things to Remember

Preoperative Care

Preoperative preparations are designed to improve the effectiveness of the surgery and decrease risks. It is vital that you meet the listed requirements in order for the operation to proceed as scheduled.

One Month Before Surgery:
  • Obtain Preoperative Clearance by Primary Care Physician- If a physical exam or certain screening tests are mandated, please make an appointment with your primary care physician or a physician of your choosing at your earliest convenience. We must have your preoperative test results and office notes from your primary care physician faxed to us at least three (3) days prior to your scheduled surgery date. You will find an order form included in your surgical packet that is to be given to your primary care physician’s office.
1-2 Weeks Before Surgery:
  • Avoid Tobacco Products- Smoking reduces circulation to the skin and impedes healing. You must avoid tobacco, secondhand smoke, and cigarette replacements, such as nicotine patches or gum, starting two (2) weeks before the surgery.
  • Stop Taking Aspirin or Ibuprofen Medications containing aspirin or ibuprofen cannot be consumed within one (1) week of the surgery as they can cause bleeding problems during and after the operation. You may substitute with medications containing acetaminophen (e.g., Tylenol) if permitted by your primary care physician.
  • Complete any Required Blood Test(s)- Test results must be faxed to our office at least three (3) days prior to your scheduled surgery date.
One Day Before Surgery:
  • Confirm Surgical Time- The surgery center or hospital will contact you the day before your procedure with your confirmed time of surgery. If you do not hear from the surgery center or hospital by 3:00pm of that day, contact our office immediately.
  • Arrange Transportation Home (For IV Sedation or General Sedation Only)- A responsible party, such as a friend or relative, must drive you home from the surgery center. Taxis, buses, and Uber or Lyft rides are not allowable forms of transportation.
  • Cleanse the Surgical Site- The night before your surgery, shower and wash the surgical areas with an antibacterial soap (e.g., Dial). Do not put any lotions, oils, or creams on your legs or feet. Please remove artificial nails and polish from your toenails.
  • Set Up Post-Operative Recovery Area at Home- This area should facilitate relaxation. Please keep necessities within an easy reach..
  • No Eating and Drinking (For IV Sedation or General Sedation Only)- DO NOT EAT OR DRINK ANYTHING WITHIN EIGHT (8) HOURS OF YOUR SURGERY. Any food or beverage intake will result in the cancellation of the surgery.

Day of Surgery

The day of your surgery can feel overwhelming, but understanding the process may help ease your anxiety. To prepare, please read through our brief summary of the surgical experience and adhere to all instructions.

Morning of Your Surgery:
  • Follow Careful Practice of Oral Hygiene- You may brush your teeth and rinse your mouth, but do not swallow any water.
  • Do Not Apply any Skin or Beauty Products- Refrain from using moisturizers, lotions, makeup, or fragrances.
  • Dress Appropriately- Please wear loose fitting clothing and/or baggy pants. Remove all jewelry. Do not wear jeans or bring any valuables with you to the surgery center or hospital.
  • Arrive Early- Please arrive at the surgery center at least 45 minutes prior to your scheduled surgery time in order for your operation to proceed as scheduled.
  • Bring Necessary Documentation- Provide your driver’s license, current list of medications, method of payment, and insurance card at your check-in.
What to Expect at the Surgery Center or Hospital:
  • Upon arrival, the friendly staff will require you to fill out additional forms and collect any necessary payments.
  • A nurse will escort you to your bed in the preoperative holding area where you will be given a gown to change into.
  • The anesthesia provider, other nurses, and Dr. Siegel will meet with you prior to your surgery to discuss the case, mark the foot, start an IV, and collect vitals. This is often a busy time, as there may be several medical professionals undertaking different tasks simultaneously in order to have you ready for the surgery on time. Dr. Siegel will go over the postoperative course with you and answer any last minute questions. You may be given pain medicine prescriptions on the day of surgery; you should plan on filling them following your procedure.
  • Once questions have been answered, all checklists have been completed, and the surgical site is confirmed, the nurse and anesthesia provider will wheel you into the operating room. During this time, the staff will make sure you feel comfortable and secure. All family members will be directed to the waiting room.
  • Following the surgery, the staff will transport you to the recovery room where vital signs will be taken and monitored. Patients are kept in the recovery room until they are in a stable condition and ready for discharge; this takes approximately 30 minutes.
  • Prior to discharge, postoperative shoes may be fitted and dispensed. Additional durable medical equipment (e.g., boots, crutches) may be dispensed during subsequent postoperative appointments at Modern Foot and Ankle.

Postoperative Care

The overall success of the operation is dependent on a variety of factors—the most important of which is your care of the surgical site during the postoperative period. To heal efficiently, please follow each direction closely.

Immediately after Surgery:
  • Follow the Step-By-Step Directions on “Immediate Post-Operative Instructions”- It is found on a document located in the back pocket of your surgical folder.
  • Relax- The surgical site will be numb for 4-6 hours after the surgery. Please stay relaxed and keep the extremity elevated. If you were put under anesthesia, we recommend that you do not operate an automobile or return to work until the following day.
  • Schedule Follow-Up Appointment- The postoperative appointment must occur within 3-5 days of your surgery.
  • Resume Regular Diet- As soon as you feel ready to eat, please do so.
  • Limit Activity- Stay home and keep your foot elevated as much as possible. This will quicken the healing process and reduce the risk of infection or other complications. All activities, such as grocery shopping, are restricted until you’ve had your first postoperative appointment with Dr. Siegel.
Days and Weeks after Surgery:
  • Follow Specific Activity Instructions-
    • Different surgeries require different postoperative activity restrictions. These instructions (found in the back pocket of your surgical folder) are not recommendations but requirements—they directly influence the outcome of the surgery. Each week you will be allowed to increase your activity incrementally; do not increase your activity level prior to being instructed by Dr. Siegel.
    • If you were provided a surgical shoe or boot, you must wear the device at all times (even for bathroom visits), unless otherwise directed by Dr. Siegel.
  • Follow-Up with All Postoperative Appointments- Missed appointments significantly increase the chance of postoperative complications.
  • Keep Your Dressing Clean, Dry, and Intact- The bandage after surgery must be kept clean, dry, and intact until your first postoperative visit; this is to prevent infections. At your first visit, the doctor will change the dressing.
  • At-Home Exercises- If ankle surgery was not performed, you may begin performing gentle range of motion exercises at the ankle and knee joint as soon as the day after surgery. Do these exercises without resistance and without bearing any weight. This helps with blood flow and prevents blood clots.
  • Avoid All Tobacco and Alcohol Products- Tobacco inhibits skin and bone healing. Alcohol dilates blood vessels and can cause postoperative bleeding.
  • Driving- Driving should be avoided while taking narcotic pain medication. If you had left-foot surgery and drive an automatic transmission, you may begin driving as soon as you are off narcotic pain medication. If you had right-foot surgery, you are not permitted to drive until given clearance by Dr. Siegel. You may NOT drive while wearing a surgical boot or shoe.

Things to Remember

Normal Postoperative Symptoms

Swelling (edema) and bruising, mild to moderate pain, bleeding, numbness, itching, and scarring are all normal postoperative symptoms. A detailed explanation of each is below.

  • Swelling and Bruising

Swelling and bruising are common postoperative symptoms. Swelling is your body’s way of healing the surgical site. Swelling comes and goes through the entire postoperative period and can last six (6) months to a year.

How to Diminish Swelling and Bruising-

      • Elevation- Elevate your operated foot above the level of your heart. Stabilize your foot by putting a soft pillow underneath your heel.
      • Ice- Apply an ice bag to your foot or ankle. Cover your foot or ankle with a towel and apply the ice to the towel. The towel will minimize the effects of the cold. Keep the ice on or above the operative site for 20 minutes; then take the ice bag off for 20 minutes. Repeat this on/off pattern for the first 24 to 48 hours after surgery, as tolerated. After 48 hours, ice as needed for pain and swelling control.
  • Pain

Mild to moderate pain is normal after surgery. More pain is expected after bone surgery than it is after soft tissue surgery.

How to Diminish Pain-

Prescription Pain and Anti-inflammatory Medication- You will likely be given two (2) medications:

1) Norco: A narcotic that is used to inhibit pain signals in the body. This will likely need to be taken the first night to help you fall asleep. It is best to start this medication within 4-5 hours after surgery when you begin to feel a tingling sensation at the surgical site, as this is a sign that the sensation (and pain) is returning to the foot. Most patients do not need to take this medication past two (2) or three (3) days.

2) Nabumetone: A non-steroidal anti-inflammatory. This is NOT a narcotic. You should take this medication twice a day with food for two (2) weeks starting immediately after surgery. This will help with pain and swelling.

Elevation and icing (see above)

Limit activity as directed by Dr. Siegel

  • Numbness

Small sensory nerves to the skin surface are cut when the incision is made or are interrupted by undermining of the skin during surgery. The sensation in those areas gradually returns, within 3 to 6 months, as the nerve endings heal spontaneously.

  • Itching

Mild Itching and occasional small, shooting electrical sensations within the skin frequently occur as the nerve endings heal. This is normal as the skin heals. Ice, skin moisturizers, range of motion exercises, and massages are typically helpful.

  • Scarring

As the incision site heals, a scar will form. All new scars are red, purple, or pink. Some people are prone to more scarring than others. Typically scars on the feet tend to fade completely within 6 months; however, patients prone to hypertrophic scars (keloids) may never see a complete fading of the incision site.

Abnormal Postoperative Symptoms

The following symptoms or findings should be considered serious. You must contact the office immediately if you experience any of the following symptoms:

  • Heavy bleeding
  • Unrelenting pain not relieved by medication
  • Dressing becomes saturated with blood or
  • Rash or extreme itching
  • Fever, chills, nausea, rash, shortness of breath
  • Unrelenting calf pain

If the surgical site has been injured or bumped into, please contact the office immediately.

Ready to Say Goodbye to Foot Pain?