Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Township, MI
Last reviewed: May 2026
| Complication | Incidence | Warning Signs | When to Call Surgeon | Treatment |
|---|---|---|---|---|
| Wound infection (superficial) | 1–3% | Spreading redness, warmth, pus | Any pus or increasing pain after day 3 | Oral antibiotics, wound care |
| Deep infection / osteomyelitis | <1% | Fever, elevated CRP, bone erosion on X-ray | Immediately | IV antibiotics, possible hardware removal |
| DVT (blood clot) | 2–8% | Calf swelling, warmth, pain with dorsiflexion | Immediately — can be life-threatening | Anticoagulation (LMWH or DOAC) |
| Hardware complication | 5–10% | Prominence, new pain at screw site | Next available appointment | Hardware removal (outpatient) |
| Nonunion (fusion fails) | 2–5% | Persistent pain, motion at fusion site on X-ray | At 3-month follow-up if symptoms persist | Bone stimulator, revision fusion |
| CRPS | <1% | Burning pain, allodynia, skin color changes | Within 2 weeks of symptom onset | Pain management, PT, sympathetic block |
| Wound dehiscence | 2–5% | Incision edges separating | Within 24 hours of noticing | Wound care, possible reclosure |
| Patient Risk Factor | Complications Increased | Risk Reduction Strategy |
|---|---|---|
| Diabetes (HbA1c >8) | Infection, wound dehiscence, nonunion | Optimize glycemic control pre-op; target HbA1c <7.5 |
| Smoking | Wound dehiscence, delayed healing, DVT | Quit ≥4 weeks pre-op; cessation doubles healing rate |
| Peripheral arterial disease | Wound ischemia, amputation risk | Vascular surgery consult + ABI before elective surgery |
| Obesity (BMI >35) | DVT, wound breakdown, hardware failure | DVT prophylaxis; stronger fixation hardware |
| Steroid/immunosuppressant use | Infection, delayed healing, osteoporosis | Discuss medication timing with prescribing physician |
| Neuropathy | Pressure ulcers post-op, missed pain signals | Strict offloading protocol; surgical boot compliance |
Quick answer: Foot Surgery Complications is a common foot/ankle topic that affects many patients. The 2026 evidence-based approach combines proper diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.
Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatrist | Balance Foot & Ankle, Michigan
The most important clinical decision with Foot Surgery Complications isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
The most important clinical decision with Foot Surgery Complications isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Understanding Surgical Risk
All surgery carries risk. For foot and ankle procedures, complication rates vary widely by procedure complexity, patient health status, and surgical experience. Understanding the most common complications allows you to make informed decisions and recognize warning signs early — when intervention is most effective.
Most Common Foot Surgery Complications
Wound Complications
Wound dehiscence (opening), superficial infection, and deep infection occur in approximately 1–3% of elective foot surgeries. Risk is significantly elevated in: diabetics, smokers, obese patients, immunocompromised individuals, and patients taking corticosteroids or immunosuppressants. Signs: increasing redness, warmth, swelling, purulent discharge, or fever — all require immediate surgical attention.
Nerve Injury
Temporary nerve injury (neurapraxia) with numbness, tingling, or hypersensitivity along the incision is common and usually resolves over 3–12 months. Permanent nerve injury is less common (1–2%) but can cause chronic numbness, hypersensitivity (allodynia), or complex regional pain syndrome (CRPS). Sural nerve is particularly at risk in lateral foot and heel procedures.
Hardware Complications
Screws, plates, and staples used to fix osteotomies can cause irritation, cold sensitivity, or pain — especially in thin-skinned patients. Symptomatic hardware usually requires a secondary procedure to remove after bone healing is confirmed (typically 12+ months post-op).
Non-Union / Delayed Union
Failure of the cut bone segments to fuse (non-union) or fusion taking longer than expected (delayed union). Risk factors: smoking (dramatically increases non-union risk — smoking cessation 4+ weeks pre-op is strongly recommended), diabetes, vitamin D deficiency, poor blood supply. Diagnosed by serial X-rays and CT scan.
Deep Vein Thrombosis (DVT)
Blood clot formation in the deep leg veins during immobility post-surgery. Risk is highest in the first 4 weeks after surgery. Signs: unilateral calf pain, swelling, warmth. Prevention: early mobilization as permitted, elevation, compression stockings, and in high-risk patients, anticoagulation medication.
Recurrence
The underlying deformity (bunion, hammer toe, etc.) can recur — particularly if the root cause (tight shoes, abnormal biomechanics) is not addressed post-operatively. Orthotics and footwear modification after surgery reduce recurrence risk.
Reducing Your Personal Risk
Stop smoking at least 4 weeks before surgery. Optimize blood glucose control (HbA1c below 7.5–8%). Correct vitamin D deficiency pre-operatively. Lose weight if BMI is significantly elevated. Follow all post-op instructions precisely. Attend all follow-up appointments.
FAQ
How do I know if my foot surgery is healing normally?
Normal healing: swelling that peaks at 3–5 days then gradually reduces, mild-moderate pain that responds to medication and improves week by week, wound edges that remain together and dry. Abnormal: increasing pain after initial improvement, expanding redness, wound discharge, fever, or swelling that is getting worse after day 5.
Dr. Tom’s Recovery Kit
Menthol + arnica + magnesium for post-injury and post-surgical soreness. Apply 3-4x daily.
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Michigan Foot Pain? See Dr. Biernacki In Person
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Podiatrist-Recommended Products
These are the products Dr. Tom recommends most often in his clinic at Balance Foot & Ankle for lasting foot pain relief:
- PowerStep Pinnacle Arch Support Insoles — #1 clinic recommendation for arch support and heel pain relief
- Doctor Hoy’s Natural Pain Relief Gel — Fast-acting topical relief used and trusted by podiatrists
- CURREX RunPro Insoles — Dynamic arch profile for active patients and runners
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. These recommendations reflect genuine clinical use.
AAOS OrthoInfo: Foot Surgery Complications
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Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.