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Old 08-26-2012, 04:57 PM   #1
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Location: San Francisco, California, United States
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Four & a half months post-op Dr. visit for Flat Foot Reconstruction

Hello all,

I haven't posted in a while. I've been doing what many of us do once we begin walking and moving again - becoming busy with my life.

The four and a half month post op visit with my doctor went well. She looked at my surgical (right) foot and had me turn around so she could see the position of the calcaneus and arch relative to my non-operative left, over-pronated flat foot. Her response: "Your foot looks good . . . Your foot looks damn good!" She seemed very happy and might I say, proud of her work. Her comment was a surprise to me as she is rarely exuberant and often conservative in her manor of speaking. So that is the upside: the operative foot is indeed much more structurally normal than it was and looks much better than the left foot which has PTTD (I better not say that too loud or I'll embarrass the poor thing).

So now I have an arch in the right foot due to the Evan's procedure (lateral column lengthening) and with the medial displacement calcaneal osteotomy my calcaneus bone is positioned directly under the ankle when looked at from behind as opposed to subluxed laterally (to the outside of the foot).

The pain along the posterior tibial tendon and the new FDL tendon that was attached to the navicular bone is diminishing as the weeks go by. The muscles in the foot are growing stronger and I can feel this too as I do my PT or with the general walking/standing that I do. Also, I can keep the foot down all day and there is generally little pain or swelling from doing this. Sometimes I still use ice.

I did want to comment and ask a question about two issues that are a concern. I have heard a few people who have had the Evan's procedure, complain that they feel like they are stepping on the outside of the foot. I would concur with this. Since I have rigid flat foot as opposed to a flexible flat foot, I was bound to have the foot set at an angle with more pressure on the outside of the foot than the inside (especially where the forefoot touches the ground). Often by the end of the day or even after walking about 7-10 minutes, the 5th metatarsal -the large bone just behind the small toe- aches with pain until I stay off of it for awhile. The Dr. and the PT said I need to get used to the new foot and that maybe the ligaments (which is probably where the pain is coming from) will "stretch out." The doctor said she would prescribe an orthotic if, in 4 more months, I was still experiencing this pain. Has anyone who has had the Evan's procedure experienced this pain and did it decrease over time?

Also, and unfortunately, after cutting my FDL tendon away from the little toes to use it as a secondary PTT, she sutured the remaining stump of the FDL tendon to the FHL tendon (the little toes tendon to the big toe tendon) and I lost the function of my big toe (with additional pain every time I attempt to flex the big toe). The result is that I can no longer curl my big toe downwards and the little toes did not seem to gain any more strength out of this procedure. I so wish she had not done that and instead left the big toe alone.

Anyway, did anyone else have this problem? Did you ever recover the ability to curl your toe (toes)?

Thanks for reading and sorry about such a long post!

 
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Tags
calcaneal osteotomy, evan's procedure, flat foot arch reconstruction surgery, pttd



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