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Old 02-18-2012, 09:32 AM   #1
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Calcaneal Osteotomy without tendon work?

Hi, I am new here. Iíve been reading lots of posts and found the site very helpful!

I am having a calcaneal osteotomy on 27 Feb, with possibly tightening of the LFT ligament, but no tendon work. Has anyone had the calcaneal osteotomy on its own? I am wondering what the recovery will be like. Iím a bit confused: my surgeon is going to fix it with two internal screws and says I will be able to weight bear as tolerated straight away. And that it wonít hurt much My physio (who has worked with other patients whoíve had the same procedure) says that osteotomies are painful and usually non-weight bearing. Most of what Iíve read here and elsewhere on the net suggests that my physio is right!

This is not my first ankle surgeryÖ I sprained the ankle about 6 years ago and had debridement and drilling for OCD 9 months later. It was supposed to be an arthroscopy but turned into open surgery with 4 weeks NWB. I was so unprepared! I have learned from this and am much more organised this time. Anyway, long story short, I have wound up with flat foot on that side and hence the upcoming surgery, which I have been putting off for ages because of other health problems. I have back and shoulder pain and am really worried about being NWB on crutches. I really canít get very far on them. Renting a knee walker doesnít seem to be an option here (French/Swiss border) but I have ordered some ergonomic crutches in the hope that they will help. I have read the tips on NWB after surgery thread, there are so many useful things there. I had to work everything out for myself the first time!

I am due to have three nights in hosp Ė will I be able to manage at home on my own after that? DH is at work all day but around in the evenings.

Anyway, I think Iíve rambled on enough for a first post. I wanted to say hi to everyone as there seem to be a few others having surgery around the same time as me.

A

 
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Old 02-18-2012, 01:21 PM   #2
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Re: Calcaneal Osteotomy without tendon work?

I am suprised that your doctor said that you can weight bear. I had the osteotomy and tendon work. I was NWB 8 weeks. I would never have been able to be on my own right away. I was in the hospital three nights and found that I needed an amazing amount of help for the first three weeks. Had you gone for more than one opinion? What was the post op plan suggested by the other doctors?

 
Old 02-19-2012, 10:47 AM   #3
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Re: Calcaneal Osteotomy without tendon work?

Thanks for your reply Roxygirl. I didn't have any other opinions... have been with my doc a long time and she is a very well respected foot and ankle specialist, so I didn't think I needed to. Now I am wondering! I do think it is odd about the weight bearing. I will ask her again but won't see her till the op. I can't imagine I will be able to put weight on it to start with anyway as I should think it will hurt too much! Any other views on this?

I'm a bit worried about being on my own... although I managed last time. Friends and neighbours came to visit and help, and take me to appointments, but not every day. My husband cooked in the evening. We have a downstairs bathroom, so I only use the stairs twice a day - came down the stairs on my bum in the morning and went back up on my knee in the evening. Other than that I lay on the couch with my foot up and watched a lot of TV and read a lot! Managed to make it to the bathroom on my own. I'm hoping that it will go pretty much the same way this time. Food will be difficult but I have an office chair to scoot around the kitchen on. We have a big walk in shower and I plan to have a shower in the eve when DH can help.

What else will I need help with - have I forgotten loads of things?

I figured out if I come out of hosp on Thursday, then I only have one day on my own before it's the weekend - then by Monday I will be a whole week out from surgery. What was the pain level like after a week?

Thanks everyone!

 
Old 02-24-2012, 05:34 PM   #4
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Re: Calcaneal Osteotomy without tendon work?

Hi, just bumping this up to ask again if anyone has experience of the calcaneal osteotomy without the tendon work - I am wondering how the recovery will go.

Also wanted to know what people's docs ordered re weightbearing?

Anyone?

Well, I had my pre-op today. Seemed to go ok, and the hosp (a new one for me) seems very organised. Met the anaesthetist who didn't seem too phased by my list of 6 surgeries (only one ankle one) and long list of meds. I always worry about pain relief as I am already on opiates for chronic pain. At my last op the nurses screwed up and wouldn't let me have my breakthrough meds, even though they had been prescribed. But he was good about it, said I could have a morphine pump after and then we would work together on an increased dose of my regular meds if necessary.

Sorry, rambling a bit now...nerves kicking in. I forgot to ask about the nerve block - I'm pretty sure I will be having one. Do they do it while you are still awake, or after they've knocked you out? Am hoping for the latter of course!

Thanks,

A

 
Old 02-24-2012, 07:09 PM   #5
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Re: Calcaneal Osteotomy without tendon work?

Hi A,

I had the arthroscopic drilling done Jan 23rd. Obviously not what your having this go round. I was given the nerve block after I was knocked out.

My doctor has me NWB for at least 6 weeks but could be 8. The operative word Your doctor said was bear weight as tolerated. If you can tolerate bearing then don't. Take it slow. It is a great idea to clarify with the doctor prior to surgery when she comes to speak to you. Recto firm with her before being discharged from the hoists. Make sure all instructions are in writing when you leave so you'll have something to refer back to once you get home.

Best of luck to you on Monday.
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Old 02-24-2012, 07:11 PM   #6
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Re: Calcaneal Osteotomy without tendon work?

Hi A,

I had the arthroscopic drilling done Jan 23rd. Obviously not what your having this go round. I was given the nerve block after I was knocked out.

My doctor has me NWB for at least 6 weeks but could be 8. The operative word your doctor said was bear weight as tolerated. If you can't tolerate bearing then don't. Take it slow. It is a great idea to clarify with the doctor prior to surgery when she comes to speak to you. Confirm with her before being discharged from the hospital. Make sure all instructions are in writing when you leave so you'll have something to refer back to once you get home.

Best of luck to you on Monday.
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Old 02-25-2012, 03:26 AM   #7
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Re: Calcaneal Osteotomy without tendon work?

I am also very surprised that your doctor has told you that you could weight bear following a calcaneal osteotomy. The bones need time to heal and fuse. I had a calcaneal osteotomy as part of my flatfoot reconstruction surgery in 8/2010. I was NWB for 8 weeks. Before beginning partial weight bearing, xrays were taken to be sure it was fused.

Being by yourself the first couple of weeks is doable but very difficult. Will someone be able to get a cooler with drinks and food for you for the day? I was pretty much by myself following surgery but I had a wheelchair as well as crutches. The wheelchair was good if I needed to get food prepared.

 
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Old 02-25-2012, 09:27 AM   #8
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Re: Calcaneal Osteotomy without tendon work?

Hi,

I'm also shocked that your doc said you could bear weight. I had the calcaneal osteotomy combined with a modified brostrom and gastroc recession. There was no way I could have put any weight on my foot. The pain without weight bearing was very significant, especially the first few weeks.

1. Since you are going to be heavily medicated and on your own, I strongly recommend you make a chart before the surgery to keep track of your meds. This will help you avoid taking too much/too little. I made a spreadsheet with the medication name and dosing instructions at the top. Below each one, I would write in the time I took the medicine and the number of pills.

2. Set a pillow in front of the toilet for you to rest your foot on.

3. Have multiple water bottles by your bed. The drugs dehydrate you pretty bad and it's very difficult to get up to fill them.

4. Keep some snacks next to your bed - bread, chips, etc.

5. Make sure you get a nerve block. I can't imagine the pain without one. Also make sure you stay ahead of the pain for the first week.

For the first week+, you are not going to want to move around too much. I didn't even leave my bedroom for about a week.

Good luck!

 
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Old 02-25-2012, 09:36 AM   #9
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Re: Calcaneal Osteotomy without tendon work?

I am also suprised that your doctor said that you could weight bear. Most people who have a calcaneal osteotomy are NWB for 6-8 weeks. A raised toilet seat which could be purchased in any chain drug store is a life saver

 
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Old 02-26-2012, 01:13 PM   #10
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Re: Calcaneal Osteotomy without tendon work?

Hi, thank you all so much for your advice. It's really helpful. I will definitely clarify the weight bearing issue with my doctor. It does seem very strange. Now I am wondering if she is going to put me in a brace so I can walk on it... anyway I will find out soon!

Will be in hosp for 3 days so hope the worst pain will be over by the time I get home. Have my DH primed to leave me food and a flask of tea before he goes to work. Various friends are "on call" if I need anything. Have rearranged stuff around the house to make things easier for myself. So hope I will manage. I feel a bit like I am about to take an exam - have I prepared enough?!

Going in tomorrow morning (27th). Still scared about the pain and loss of liberty, but can't wait for the surgery to be over now!

Will let you know how it goes...

 
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Old 02-29-2012, 11:53 AM   #11
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Re: Calcaneal Osteotomy without tendon work?

AMETHY5T--hey girlie! How are you doing? How are you feeling? How did your surgery go? Update us as soon as you are able! Hope you aren't in too much pain!

 
Old 03-04-2012, 05:48 AM   #12
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Re: Calcaneal Osteotomy without tendon work?

Hi all, Thanks Hollywood for checking up on me! My head is still a bit fuzzy from the meds and anaesthetic so haven't been online much.

Surgery went well, my surgeon is really pleased with me! Had a bad time with pain afterwards - when I woke up in recovery it was excruciating, like nothing I have felt before! They kept giving me more drugs and nothing seemed to work. It felt like it took ages to get the pain under control but actually it was only a few hours. Was completely out of it the whole day though - my surgery was at 1pm and I didn't wake up enough to eat that evening!

Anyway, she did the calcaneal osteotomy, drilling for OCD and the PRP treatment. Good news is that she was really pleased with the osteotomy. Bad news is that I have no cartilage over the top of my talus. She is hoping the treatment will encourage it to grow back, but said it's kind of the luck of the draw. But at least now my foot will have a better position so hopefully there will be less bone on bone contact.

She got me out of bed the second day and made me walk on it! I was so scared but it was fine! I am on crutches but able to put a little weight on the front of my foot. It doesn't hurt to do that, I can't quite believe it! I have no cast, just bandages, and a special shoe. She says there is no way I can damage it, she has fixed it with 2 enormous screws!

Came home on Weds (2 nights in hosp). Still have to keep foot elevated for now, and am resting most of the time. Doc is keen for me to get up and walk around often though. My whole body was killing me to start with from using the crutches but have got used to them a bit now. I just can't go very far - not very strong or fit!! A friend came in my first two mornings home and she helped me get downstairs and get me food etc. She was fantastic. My hubby has been around over the w/e and he's been great too. So I'm keeping really postitive. Will need help with the stairs for a bit but I think I will manage with a rota of friends and neighbours coming in.

Thanks again to all the support. Will catch up with everyone soon. So pleased to see that others have come through their surgeries well.

A x

 
Old 03-04-2012, 07:49 PM   #13
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Re: Calcaneal Osteotomy without tendon work?

So glad you are doing well! Been worried about ya! I am jealous you've already gotten to bear weight! LOL! Thats great that you have so many friends/family to help you and they are coming around a lot! That is how it's been with me too. We've had dinner brought to us every other night and sometimes every night and will through at least March 20th! Such a big help not only food wise, but company for me. I've gotten out some too, but the majority of the time is on my couch! Sounds like your pain is under control now too which is great! How long are you NWB or are you fully WB as tolerated?

 
Old 03-07-2012, 05:12 AM   #14
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Re: Calcaneal Osteotomy without tendon work?

I am weight bearing as tolerated, on the front of the foot, for 6 weeks, with crutches. I guess they will check then to see how the bone has healed. I have a surgical shoe that stops me from putting weight on the heel. The reality is I can't put much weight on the foot, maybe 20%? I feel really lucky that I can do that and that I don't have a cast. Even so my shoulder is killing me by the end of the day... and my right leg, which has to do most of the work of course. Otherwise I am feeling OK, but pretty tired. I'm still on painkillers (Oxy) but I was on them for chronic pain before the surgery. I had to augment the dose after the surgery but am nearly back to the original dose now - yey!

My doc has told me to stay off anti-inflamatories for the moment as they will affect the healing from the drilling for OCD. I guess it's because the drilling generates an inflamatory reaction, which is necessary for the bone to 'bleed' and make new 'cartilage'? Anyone know? I'm finding this really hard as they help my back a lot... and of course the crutching is making my back worse!

I am really hoping the drilling will work. I've had it before in 2005, when my surgeon had to remove lots of loose cartilage, which had become detatched after a bad sprain. It wasn't very successful.

Anyway, anyone else had all this without a cast? Still seems unbeliveable to me, but my surgeon is very good and pretty progressive, so I do trust her!

Oh, one other question: I can't move my little toe much. Is this normal? It moves up and down with the rest of my toes but not outwards, if you see what I mean. I am finding it really spooky!

Hollywood - so glad you have lots of help and visitors. It makes such a difference, doesn't it? It's so great that people are bringing you food. I have lots of stuff in the freezer and my DH is cooking sometimes. He is out till late tonight so I am going to friends for the evening, otherwise I think I would go hungry! My first outing beyond the front garden!

Sending healing thoughts to all my fellow recoverees!

 
Old 03-07-2012, 05:26 AM   #15
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Re: Calcaneal Osteotomy without tendon work?

I can't believe your surgeon didn't give you a nerve block! Ouch! Glad everything is under control now.

I had limited movement in my smaller toes for weeks. The nerve gets jostled/irritated during surgery and that affects the feeling and movement of the foot. I'm nearly a year out and still have some numbness in my ankle.

Good luck with your recovery!
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Calcaneal Osteotomy, Modified Brostrom Repair, Gastroc Recession, Screw Removal, Achilles Debridement, Haglunds Deformity, PIP Arthrodesis, FTL Tendon Transfer, MTP Capsulotomy, K-Wire Fixation

 
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