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Old 03-29-2011, 05:32 PM   #1
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PTT debridement and peroneal tendon tears repair

In reading these posts I see a number of people have had PTT surgery and/or peroneal tendon brevis and longus tear repair surgery. I am set to have these procedures next week along with lateral and medial ligament repair. I previously had a subtalar fusion so I have some idea about post-op foot surgery recovery. I was back to work in 8 weeks from my previous surgery.

Since my previous surgery was bone related, and this surgery is tendon related, I feel ill prepared. My question for you out there is "how soon post surgery will I be able to return to work", realistically.... I am on my feet up to 12-13 hours in a full days work...

Any thoughts from those of you who have experienced any of the above procedures would be much appreciated...
Thanks,

 
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Old 03-29-2011, 06:09 PM   #2
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Re: PTT debridement and peroneal tendon tears repair

I am 7 months post op calcaneal osteotomy, kidner procedure, achielles tendon lengthening, ptt repair and fdl tendon transfer. I was non-weight bearing for 8 weeks. I was out on disability for four months following surgery. I work for a hospital as a respiratory therapist and my job requires me to be on my feet all day. I returned to work in January and I have to admit it has been harder than I thought it would be. I have to be able to move quickly and be able to intubate patients if necessary. My doctor had a custom made brace made for me because he felt (in February) that my foot was no where near ready for the demands of my profession. Before the brace had come in, I had a stress fracture of my tibia - turns out my muscles and tendons were over-used, stressed-out and this transfered to be tibia. I am now back in a boot until April 17th. Be sure your doctor is well informed of the requirements of your job and how long you will be on your feet. It really does take a full year to recover. Even with this, I am glad I had surgery and really do consider it a success.

 
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Old 03-29-2011, 06:30 PM   #3
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Re: PTT debridement and peroneal tendon tears repair

My procedures were similar to Missy Lukes. I am eight months post op. I am a school based speech therapist working with preschool disabled and autistic children. Although my job allows me to alternate between standing, walking and sitting, I have to be fairly mobile. My surgery was in July and I returned to work in December. My doctor had me wear the boot for the first few weeks back to work to protect my foot and then wear shoes with an ASO brace for another few weeks. I am doing well now. I agree with MissyLuke that you want to be sure that the doctor knows the physical demands of your job so that you allow yourself to fully recover

 
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Old 03-29-2011, 07:24 PM   #4
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Re: PTT debridement and peroneal tendon tears repair

I am a neonatal nurse practitioner in a Level III nursery. Now I understand that might not mean a whole bunch to you but my job entails responding to critical infants in the NICU or a delivery room within a moments notice--to intubate, resuscitate, or whatever else may need to be done to correct the emergency situation. Although I am not required to 'run', often times when an infant is in trouble, I feel I must... I also spend a lot of time placing central lines which entails standing for hours at a time. I could go all day and never sit except for brief periods of time.

My physician knows my job title, but I guess I am not sure whether he really understands all of my responsibilities. Doc said I will be NWB for only 4 weeks. He seems to think I will be back to work in 6 weeks...after reading all these posts, I am not sure I will be back in 12 weeks!

I appreciate your info. I am currently off work on crutches and have been for 5 weeks. I will be anxious to get back to work, but want to be smart...

 
Old 03-29-2011, 07:31 PM   #5
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Re: PTT debridement and peroneal tendon tears repair

I can't really relate to many of the procedures you are having, as your surgery sounds much more involved than mine was, but I did have a lateral ligament reconstruction. I was off work for 8 weeks. I am also on my feet at my job all day long. I really struggled in the beginning, and think I went back too soon. Right when I went back to work is when I began having problems which I am still having now 4 1/2 months later. Be sure that you don't return too soon, you don't want to ruin what was done.

 
Old 03-29-2011, 08:20 PM   #6
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Re: PTT debridement and peroneal tendon tears repair

I was NWB for 8 weeks and then I wore a boot ANY time my foot touched the ground. When I started wearing the boot, I was allowed to do light weight bearing. Over a period of three weeks, I slowly increased the amount of weight on my foot until I was able to FWB in the boot. At about 3 1/2 months post op, I was able to wean out of the boot. My doctor said that for flat foot reconstructions, he usually keeps people who have a desk job out from work for around three months and four months if the job requires you to be on the feet a lot. He had me wear the boot for a few weeks when I returned to work to protect my foot. It is definitely not worth rushing things. Considering how involved the surgery and recovery was, I agree that you don't want to damage your new foot. My surgery took around 4 hours and I was in the hospital for three nights post op.....mainly for pain control. I know that my surgeon is cautious, but that was fine with me. My surgeon has a special interest in flat foot reconstruction and does many of them each year. My physical therapist is amazed that I am pretty much pain free with the exception of occasional twinges here and there and residual reduced sensation in my toes. Consisering how my pain I was in prior to surgery, I am thrilled with how I feel now. I am going to see the doctor next week for possibly my last appointment with him. I traveled into NYC (1 1/2 hours)each way to see the doctor. The drive in was a hastle but well worth it.

Don't push yourself. A few months out of your life is no big deal in the scheme of things

 
Old 03-30-2011, 02:39 AM   #7
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Re: PTT debridement and peroneal tendon tears repair

I do understand your job as I sometimes work in the NICU. You have to be able to move quickly and returning to work in the timeframe you have been given seems to soon. I work as a respiratory therapist at a hospital and there are times where I am standing in one place for a period of time. Although it seems standing in one place would not be that bad, it is. It can be painful at times. Four months out might not have been long enough for me. Before returning to work, my doctor had told me that my healing was above the curve. Knowing this, I thought returning to work would not be that bad. Turns out it can be that bad. By one o'clock in the afternoon (I start work at 7:00 a.m.) I am hurting. I have a stress fracture in my tibia due to stress on my tendons and muscles in my foot/ankle. Just be really careful that you are truly ready for the demands of the hospital.

 
Old 03-30-2011, 09:18 AM   #8
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Re: PTT debridement and peroneal tendon tears repair

I appreciate everyone's insight. Surgery is next week, so I will see how it goes. I will be sure my doc knows the demands of my position as that is very good advice. Thanks!!

 
Old 04-22-2011, 02:46 PM   #9
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Re: PTT debridement and peroneal tendon tears repair

Hi,

I'm just wondering how your surgery, and recovery is going. I am a registered nurse and work on a busy cardiac unit caring for 4 to 5 patients at time. I obviously spend a lot of time on my feet. After 4 months of ankle pain, multiple podiatry appt, and wearing a brace everyday an MRI was ordered. I was called Monday and told that I have a significant 5 cm tear to my peroneal tendon, and the only way it will likely recover is with surgery. I've been placed on light duty and in a cam boot for fear of further injury, not know if it has worsening in the last few months. I'm awaiting clearance from my pcp for the surgery and it should be within the next week or two. My surgeon has told me I'll be non weight bearing for 8 weeks, first with a splint, then to a cast, and then in a boot till 10-12 weeks post op. At this point she feels I'll be able to return to full duty. Does this sound realistic? I'm really worried about not being able to function as needed. On top of all this I have a busy 2 year old toddler, that will make recovery challenging. I don't want to put surgery off because I've been warned that by doing so I can cause more damage, making surgery more difficult, and making recovery more difficult.

Last edited by BonnieR; 04-22-2011 at 02:48 PM. Reason: verbage error

 
Old 04-22-2011, 03:44 PM   #10
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Re: PTT debridement and peroneal tendon tears repair

Dear BonnieR:

First and foremost I agree with whomever told you that "if you don't have surgery you can do more damage" because that is what happended to me... I do not think my first surgeon treated me appropriately when I first started to complain. He had me do PT but did not immobilize or decrease my work time. With every step I felt a ripping, tearing pain up both sides of my leg which were almost unbearable after 6 weeks. My MRI after 2 weeks showed tears in my peroneal tendons but not my posterior tibial tendon, and when the surgeon saw my tendons, the posterior tibial tendon was torn from my midfoot to my tibia. I whined and whined loudly, but the first doc never listen and told me to keep exercising. I think by the time I switched docs, the damage had already occurred as I was on crutches by then because I just couldn't stand the pain any longer. Anyway, in my opinion, for a tendon tear, having surgery sooner is better.

You will defnitely need help with your 2 year as I have a 6 year old I need help with. I can only be up briefly, and she just does not always understand.

I don't know that specifics of your case but I had more work done than expected: repair of a long posterior tendon tear, lateral ligament repair, multiple peroneal brevis tendon tears, sural nerve de-entrapment, and removal of subtalar pin. I also had navicular bone chips removed and the bone shaved, and bone chips removed from the subtalar area, as well as an arthroscope of the ankle joint. So, my recovery has been extremely painful to say the least. The doc had placed me into a cam boot on Tuesday but I have been so uncomfortable that today I was put into a cast, and so far, I am much more comfortable.

The doc still says I can try and walk in 2 weeks, but he is not so sure I will be successful. Since I had so much work done, my recovery may not mimic your recovery. My doc says he has patients NWB anywhere from 4 weeks to 8 weeks depending on the person. He prefers to let the patient guide themselves. With that being said, I have read that most are NWB at least 6 weeks for a tendon tear. Soft tissue takes about 6 weeks to fully heal. After the first 2 to 3 weeks, you will feel better and may not need as much help, but I would definitely set-up some sitters for your toddler during the first 2 weeks, at least.

Also, I expect to make a full recovery, and I believe pending health issues you did not share, you should as well. I will say that I will be cautious in the future with my feet. I have orthotics, and plan to wear comfortable supportive shoes and support hose once back to work. I like you are on my feet all day at work. It may take some time to be pain-free, but I do not plan on changing my profession any time in the near future. Although, I have been told that my life with sandals is over...

I wish you luck, and hope that you have no surprises hidden in your foot!!

 
Old 04-23-2011, 09:04 AM   #11
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Re: PTT debridement and peroneal tendon tears repair

Thank you for sharing. I do appreciate it very much. I have to say that I am a little anxious about the surgery. I am use to pushing myself through things that just must get done, but I most certainly want to recover from this surgery properly and it sounds like it will be the first thing to slow me down.

I do hope that you have a quick and full recovery. If you have time please post updates during your recovery. I am worried about returning to work. I will definitely take your advice on the sitter end of things, because my 2 year old is a very busy one.

What did your surgeon give you for pain mgmt? I usually don't take pain medication, but my doctor did give me a percocet script to get filled and from what I've been reading it sounds like I will need it.

Thank you again for sharing.

Bonnie

 
Old 04-23-2011, 09:56 AM   #12
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Re: PTT debridement and peroneal tendon tears repair

BonnieR:

I can definitely relate to the fact that 'very little slows me down' as I am the same way...may be that nursing thing in us. Anyway, yes, indeed, this has stopped me in my tracks.

After surgery, you will want to keep your foot above your heart as much as possible. And keep ice behind your knee. Since you will have a large dressing on your foot, you won't be able to directly ice your foot, and the ice behind your knee indirectly cools your foot--and it is really very helpful. One other very important aspect of your recovery will be physical therapy. After my first surgery, I was not sent to physical therapy right away, only after I failed to recover on my own. This time I will be going to physical therapy in 2 weeks; at the point where I am allowed to start weight bearing.

Check out this board for the posts related to how to prepare for foot surgery. Since this is a foot problem board, there are many people who have had foot surgery and wrote down some great ideas that you may find to be helpful as you prepare for your surgery. Let me know if you have trouble frinding them as I could help direct you to those posts...

Percocets are the pain med of choice. Although initially my doc prescribed them as 1 every 4 hours, my dose was increased to taking 2 every 3 hours for several days. Now, 2 weeks post-op, I am only taking 1 every 6 to 8 hours. As long as I am recumbent on the couch, I could go pain med free, but because I have to get up to use the restroom, or bathe, I require some kind of analgesic on board. And I don't get up off the couch for much else at this point. Overall, with the placement of the cast yesterday, I feel so much better, and hope that the remainder of my recovery is event free!!

Please keep me posted as to your surgery date. And if I can help you in any way, please just let me know. Good Luck!!

 
Old 05-02-2011, 07:33 PM   #13
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Re: PTT debridement and peroneal tendon tears repair

I hope that all continues to go well with your recovery. My surgery is planned for next Tuesday, May 10th. I'm usually not a very anxious person, but the stress is starting to build. Half the battle thus far has been dealing with my short term disability case manager at my job. She has absolutely no drive to be proactive, and a real problem with returning phone calls. I picked up my crutches, have somenone lending me a roll about scooter, am getting a wheel chair and shower bench on lend. I thought maybe the shower bench would help me to keep my leg elevated while showering. Showering seems to be of a big concern to me. Any updates? How are things going for you? I'm still concerned about being able to return to those 12-13 hour days of standing at the 12 week mark.

 
Old 05-02-2011, 09:29 PM   #14
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Re: PTT debridement and peroneal tendon tears repair

BonnieR:

I will be thinking of you on the 10th. That day is the next time I see my surgeon. I am progressing. Last week when I saw the surgeon he thought my cast was too tight as my toes would immediately turn blue when my foot was down and then it would take 15 to 20 minutes to pink up once I was back on the couch. He split the cast and put it back on with padding to make it loose, and taped it together. I looked so ridiculous that I put myself into the cam boot which took a few days to get used to wearing. The doc said I could do either as long as I was comfortable.

The incision on the outside of my foot has necrotic edges so he did not want another cast. He didn't like the idea of closing it up in a warm environment as he wants me washing the foot now. Showering is tricky. I have a stall shower and use a shower chair which works pretty well. I just have to think ahead as to what I need within reach before removing the boot. Initially, you won't be able to get your foot wet, but once you are allowed, the bench will be helpful.

This week I have been able to have my foot level and tolerate that position pretty well. So I can eat at the table without too much trouble. I am also suppose to start weight bearing. I have to call in the morning and update the doc at which time I need to clarify the weight bearing process. Last week he said something about putting the foot on the floor and I am not sure whether he means point touching or actual weight bearing but I will ask in the morning.

I understand your concern about being able to be on your feet at the 12 week mark. I am certainly hoping I will be there. The plan for me is to return to 8 hour shifts at around 8 weeks. 8 hour shifts are not really an option for my position but my manager has requested I start there. I am also very sorry that your STD person is frustrating you. My employer has been very easy to work with and they have initiated a lot of disability conversations. The integrated disability office where I work said they would even allow me to return to work using a knee walker. I was very surprised but they are the ones who called me and suggested I pursue the purchase of one. I am hoping that will not be necessary. I will know better in the next few weeks as I start weight bearing.

Hopefully, you have sitters lined up for your toddler. The first few weeks will be your greatest challenge. After that you might be able to be up for short periods of time. Be sure to rest when your toddler rests and leave the house work for someone else...no matter how much it bothers you Mine bothers me a lot and I tried to bite the bullet and take care of it as it was my daughter's birthday...do not make my same mistake! Now, I do a bit here and there, and let the majority of it fall on my husband and older kids. Of course, they don't do it the way I would but at least they are trying...

You might consider practicing on the crutches over the next week. I was on crutches 6 weeks before surgery so pretty adept by the time surgery came. A walker was most helpful for me for at least a week as I was too unsteady on crutches while taking routine pain meds. Also, you might want a small backpack to carry things from place to place while on crutches. I have a draw-string bag with shoulder straps that I use to take things up and down stairs or carry magazines or books to doc office visits.

My pain level is much more under control. I do hope you are able to control your pain post-op. Keep your foot up and ice behind the knee--I am still icing almost constantly. The swelling in my foot has drastically improve over the last few weeks.

Well, good luck and I will check in on you next week. Keep in mind that you can't go on like you are right now, and surgery is a fix. It may be painful initially, but your foot will be better for it in the end. GOOD LUCK!!

 
Old 05-02-2011, 10:38 PM   #15
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Re: PTT debridement and peroneal tendon tears repair

Yes, it is the same foot I had the STJ Fusion on last year. I can say that this surgery has been much more painful than last year. My doc agrees with you that 8 weeks is possible, and I am ready to start the rehab process. I am not use to sitting in one place for long periods of time and I have been stuck on the couch for over a month...

 
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