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Old 07-22-2012, 09:16 AM   #1
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Issues 2 months after Brostrom procedure and clean up

8 weeks ago I had a Brostrom procedure, repair of a partial tare to the medial ligament and arthroscopic clean up of chips from a talar dome microfracture. I went to see the doctor about 2 weeks ago and while he was flexing my foot up and down, the tendons were popping in and out from behind the fibula (presumably the posterior talofibular ligament) and there was some crunching underneath the fibula. He told me this was not normal and told me to begin PT to see where things go and that I may need another MRI.

PT has made things worse. I have very limited range of mobility, complete weakness and instability and a lot of pain. It is getting slightly better, but I am still in the walking book most of the time. I have been doing PT for two weeks. The other day, my physical therapist told me that my ankle has about 5% fiunctionality and that normally a person following this surgery would have a lot more. The anterior talar tendon seems to be in a fairly constant state of swelling, pain and discoloration. Has anyone else had this issue? Thanks for any input!

 
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Old 07-22-2012, 09:40 AM   #2
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Re: Issues 2 months after Brostrom procedure and clean up

I haven't had that issue, but I do recommend paying attention to what your body is telling you. Don't rush the healing process and do inform all involved in your recuperation of what's going on, pain, mobility, etc.

 
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Old 07-22-2012, 10:32 AM   #3
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Re: Issues 2 months after Brostrom procedure and clean up

Thanks Ladderman! I am doing what they tell me to do. It just does not seem to be getting better. Actually the pain level has increased. I am letting my PT and doctor know.

I kinda think they are going to tell me I need more surgery. Does this happen a lot? How long do you have to wait after the initial surgery to get a second one?

 
Old 07-22-2012, 10:49 AM   #4
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Re: Issues 2 months after Brostrom procedure and clean up

There will be ups and downs. You're still pretty early into this adventure. Definitely don't let it consume you and little by little the bad moments will be fewer and further apart. You'll have a better idea of where it settles after a while.

Pain levels differ from person to person, so no one can actually tell you exactly what to expect and what timeline is going to fit your situation, but you can get a general idea through these boards and others. Consume everything you read. You'll get a good idea of procedures and experiences from others with similar situations as yours.

Additional surgeries depend on your progress, of course. If you take your time and are careful, hopefully you won't have to go through any more. None of them are fun, but they can produce positive results. Take a deep breath and let your body heal. It's a good investment.

 
Old 07-23-2012, 03:13 AM   #5
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Re: Issues 2 months after Brostrom procedure and clean up

I just had a Brostrom plus other stuff for the 2nd time this past Feb. the tendons popping out from behind the fibula are your peroneal tendons and they are subluxing. This is common after history of ankle sprains. In addition to my Brostrom-Gould in Feb, he also repaired a torn peroneal tendon and did a fibular osteotomy (broke and drilled the bone) to deepen the fibular groove so thr tendons will stay in place. If they keep popping out, they will fray and tear and the pain will continue. Why that wasn't caught before your surgery I don't know because that stinks! Usually it is a surgical fix, but we don't know what it is for sure yet. I would definitely request another MRI. PT might help with strength for your Brostrom (and it will swell up to 9 months post surgery. Mine would swell bad during PT and I'm 5 months out today and it still,swells and hurts. It's normal), but it could continue being painful if your tendons are popping out or if they could have tears in them. Ask your doc for another MRI! Let us know what happens!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 07-23-2012, 05:30 AM   #6
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Re: Issues 2 months after Brostrom procedure and clean up

Thanks Hollywood48 I'm not sure why they didn't catch it either, but I guess that's just my luck. I have a pretty high pain tolerance (had spinal fusion last year and it was a breeze) but I find that I am im a lot of pain nowthat I am in PT. The swelling is mainly on the inside of my ankle down but the foot arch, or on the outside between my last two toes (Very specific places!) The other thing that is happening is the crunching. If I extend my food downward more than about 0.5-1", it clicks and crunches pretty badly. I'm so frustrated.

Last edited by CKowalski; 07-23-2012 at 10:17 AM.

 
Old 07-23-2012, 08:22 PM   #7
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Re: Issues 2 months after Brostrom procedure and clean up

"clicks", I can understand. I've gotten used to those over the past 19 years. "crunches" are another thing. Your body is talking to you. Listen closely and pay attention.

 
Old 07-23-2012, 11:57 PM   #8
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Re: Issues 2 months after Brostrom procedure and clean up

Oh yeah you will have pain, numbness and tingling in your last 2 toes extending up towards the ankle on the outside. That is from them moving the sural nerve in surgery. It should go back to normal within 6 months. Mine did after the first surgery and I'm still waiting for it to go away after this 2nd surgery.

Wow! You do have a high pain threshold if a spinal fusion was a breeze for you! Not many of my patients would say that!! However, the foot/ankle is a completely different ball game. Such a sensitive area and a huge direct weight bearing joint. The pain is different so I can see where you are coming from. I will say that the pain from a peroneal tendon repair isn't much different than the ligament repair, but the osteotomy to deepen the groove so they don't pop out anymore is fairly painful. When my doctor gave me the option to add this I told him to do it because I wanted everything done so my ankle would never be opened up for the 3rd time. He said he thought it was a good choice but it would be worse for me pain wise and he was right! But nothing that pain meds didn't control and he was fabulous at making sure my pain was well controlled!

As far as the clicking, that could be the tendons snapping over the fibula but it also could be the tendons rubbing against each other OR it could be scar tissue or at worst (and I doubt it with you just having had surgery) an OCD of the talus or something. The crunching? Not sure! Scar tissue? I'd bring all this up with your doctor. You really need another MRI!!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
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