If you develop any of the following:

• Fever greater than 38 degrees Celsius
• Severe continuous, uncontrollable pain
• Continuous bleeding
• Continued, severe swelling in the limb that underwent surgery
• Inability to urinate

Call the office of your surgeon immediately. If you do not speak with someone directly, leave a message and then call St. Paul’s Hospital (604 682 2344) and ask to speak to the orthopaedic surgeon on call. If you cannot speak with the physician covering for your surgeon then please:

» Call your Family Doctor and ask for advice or arrange for an immediate assessment.

» If you cannot obtain an answer then proceed to the nearest emergency department. Your surgeon would prefer that you be seen at the St. Paul’s emergency department as this would provide best continuity of care and allow for admission if required. However, if you do not live near St. Paul’s Hospital, then proceed to the nearest emergency department.

St. Paul’s Emergency Department
http://www.providencehealthcare.org/info_stpauls_emerg.html

Below you will find the general post operative instructions as well as instructions for specific surgeries.

General Post Operative Instructions:

A sheet will be provided to you before discharge. Do not lose this sheet. The sheet contains postoperative instructions specific to your surgery.

The sheet will describe the surgery that you received. It will describe wound care instructions, follow up instructions and other instructions such as physiotherapy referrals if required.

A copy of the sheet is provided:
» Post Operative Instruction Form - Dr. Thomas Goetz

For Surgery on the Wrist and Hand:

Elevation of the extremity and the use of ice are key to avoidance of swelling and edema in the postoperative period. Edema will increase postoperative complications such as stiffness, pain and infection. For the first 4 days post-operative it is important to elevate the extremity at ALL times above the level of the heart. Typically a sling will not do this. Holding the extremity elevated when walking (“ the tired statue of liberty”, or “wave like the queen), when eating (elbow on the table) and when sleeping (prop on pillows).

For Surgery on the Elbow:

First 3-4 days:
Control of edema; elevate, use of compression sleeve, ice
Early ACTIVE range of motion (specific instruction sheets will be given to you at surgery)

First Postoperative visit (between 7-14 days)
Wound check
Removal of stitches
Possible bracing

Post-Operative Elbow Instruction Sheets for patients seen by Dr. Thomas Goetz:

» Triceps Deficient Protocol Form
» Biceps Tendon Repair Form
» Medial Collateral Reconstruction Form
» Turnbuckle Splint OT Instructions

Post Operative Shoulder Care:

A sheet will be provided to you before discharge. Do not lose this sheet. The sheet contains postoperative instructions specific to your surgery.

The sheet will describe the surgery that you received. It will describe wound care instructions, follow up instructions and other instructions such as physiotherapy referrals if required.

Post-Operative Shoulder Instruction Sheet for patients seen by Dr. Thomas Goetz:

» Shoulder Protocol Replacement Form