Dishan Singh on how to recognise a rupture of the achilles tendon

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Achilles tendon ruptures continue to be misdiagnosed Look at Dishan Singhs recent Video article on reliably diagnosing achilles rupture published in this months British Medical Journal.

Tests for a suspected Achilles tendon tear - Simmonds' Triad: Calf squeeze test (Thompson test) Altered angle of declination (Matles) Visible or palpacle gap

Bunion Surgery Diary weeks 6-12

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Surgical Shoe Off!!!!

but..... your foot tends to be a bit swollen so a nice wide fitting shoe with a supportive sole is required....nice shoes will have to wait!

If all is well you can begin driving.

some gentle low impact activity like swimming, exercise biking might be possible.

No running yet! 

You will feel frustrated that the foot tends to become swollen again quite quickly when you are standing or walking.

Bunion Surgery Diary weeks 2-6

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At about 2 weeks, the surgical dressings and stitches are removed. The foot is often a bit swollen, the excess skin over the bunion area takes a bit of time to shrink down, so don't be too worried if it still looks a bit bulky there.

Daro toe splint

Daro toe splint

Often we use a removable velcro splint, like this 'Darco splint' to support the big toe, which can be removed to bath and to work on moving the toe.

You should still use the surgical shoe to walk in.

elevate and cold packs!

physically manipulating the toe to regain movement which will be a bit sore, but is important in reducing stiffness. your surgeon will teach you how to exercise the toe.

Bunion Surgery Diary weeks 0-2

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OK! We'll start off....but please do comment on your experiences, and before long we will have a really helpful "collective experience" of bunion surgery.

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You will come back from the operating theatre with a bulky bandage. The foot is usually nice and comfortable, as the anaesthetist will have used a local anaesthetic ankle block which will leave the foot quite numb for 6-12 hours.

Once you have had something to eat and drink it is advisable to begin taking your post-operative pain medication, as directed by your doctor, whilst the foot is still numb. This may sound strange, but it makes for a gentle transition to adequate pain relief once the block wears off, you may find that you have taken 2 doses of pain relief before the feeling returns.

If you do have some discomfort or pain over the first couple of days, this usually settles by the third day.

You will have a special surgical sandal, you must wear this whenever you put weight through the foot in order to protect the surgical correction.

Elevation is the key after surgery! ideally above your heart and hips! Swelling causes unnecessary pain and doesn't help the healing process. It often helps to plan things that keep your mind occupied as elevation tends to be boring! whether its books, movies, mini-series, knitting being occupied makes it easier.

Cold packs can help, (avoid applying ice directly onto the skin as it causes ice burns!).

Wriggle your toes, bend your ankles and knees to keep the circulation flowing........................

We'd like to know about your experience of week 0-2?


hallux valgus surgery blog

/ Royal National Orthopaedic Hospital/

Welcome to my blog!

recovering from Hallux Valgus surgery?

I hope this blog will help explain your recovery and give you some valuable tips and pointers.

Please feel free to add comments. It would be really useful for patients considering surgery, to hear about your personal experiences, at various time-points during your recovery!