Possible PTTD surgery complication - Foot Problems Message Board

Becca85 · 05-31-2007, 02:01 PM

Hi everyone, I'm going to try to be as brief as possible, but my feet are extremely complicated so please bear with me.

I'm 22, and I started noticing foot problems when I was 15. When I was 18, in 2003, I was diagnosed with tarsal tunnel syndrome and had surgery in my right foot, then had the same problems and surgery in 2004 on my left foot.

Then I started having terrible pain, saw a very good surgeon, and was diagnosed with toe deformities, PTTD, severe flatfoot deformity, tarsal tunnel syndrome (again) and tenosynovitis in the FHL. I also had a shredded spring ligament. This was all in each foot.

In March of '06 I had surgery on my right foot: ant/post calcaneal osteotomy, iliac crest bone graft (combo allo- and autograft), repairs to the FHL, PTT, and spring ligament, tarsal tunnel release. I'm now 15 months post. In October of '06 I had surgery on my left foot: ant/post calcaneal osteotomy, iliac crest bone graft (combo allo- and autograft), repairs to the FHL, PTT, and spring ligament, tarsal tunnel release, FDL tendon transfer to PTT, excision of accessory navicula, medial cuneiform osteotomy. I'm now 7 months post. Finally in March of '07 I had 3 screws and a plate removed from my left foot and some bone and scar tissue that was rubbing a nerve trimmed.

Ok, that's the end of the surgical history, I promise. Here's my problem. Last August, when my right foot was just about 6 months post, I developed a pain on the outside of my foot, about an inch behind my 5th toe. It occurred suddenly, but became chronic. It does get better with rest, but if I stand for 15 minutes it comes back. My surgeon and I discussed this over the winter and his theory was that since the arch in my right foot is a little too high (it never settled after it came out of the cast) the imbalance must be causing the stress and pain, and thus I'm scheduled for July to take out the bone graft, shave it down, and reinsert to get the arch to a normal position. Everything seemed fine. However, a few weeks ago the exact same pain occurred in my left foot! It's at relatively the same point post-op as well. I called my surgeon, he's concerned, stuck both feet back in cam walkers for 3 weeks, after which I'll see him.

I've been thinking about this a great deal, and my personal theory is that since my left foot has a normal arch, reducing the arch in my right foot won't do anything. I think that raising the arch even to a normal height might be causing the problem, but since going back to flat feet isn't an option, we're going to need to find another solution. One thought is orthotics, but I'm not yet at the point where I want to commit to wearing orthotics for the rest of my life. So that leaves us looking for a surgical solution. I'm also starting to have pains going along the inside of my foot, just aches mostly. Not sure if that's relevant.

If anyone has any suggestions, or experience, I would love to hear from you. Even if it's just an idea for something to search on. If you're still reading, thank you, I'm sorry it's so long.

snwtygr · 05-31-2007, 05:25 PM

after such a big reconstruction, orthotics are almost always required. I'm surprised you haven't been wearing them since the surgeries. Anyway if you had them and evaluated how you feel after a period of time it would at least help make a more accurate diagnosis of what the exact cause of the pain is. It sounds like he's doing alot of guessing and further surgeries without an accurate diagnosis sounds dangerous. A second opinion would be a very good idea. Sometimes a fresh perspective can do wonders. Also, most orthotics are unnoticable in most shoes. Nobody knows I have them and I forget they're there alot of times. They fit in my shoes and I'm not restricted in shoe choices. Please keep us posted on how you're doing.

Becca85 · 05-31-2007, 05:50 PM

I wore orthotics for years before the surgeries, and my surgeon said I didn't need them after the surgeries. Certainly I'd need new ones. My issue with orthotics is that I hate having to wear close toed shoes with a back, which is pretty much a requirement for orthotics. My feet always hurt less in sandals, but they don't tend to acommodate orthotics.

I trust my surgeon, and he'd be the first person to tell me not to do a particular surgery. He's done it in the past. His guess about the arch was based on 9 months of data showing pain at the pressure point from where the high arch was pressing into the ground. I was comfortable with it. This new event with the pain in my other foot threw us both for a loop, and I know he won't do anything further without getting a handle on it.

Getting a second opinion is a good idea, there are some very good surgeons in his practice, although he's the chief of the center. I plan on asking him to try to reevaluate my feet as if he were seeing them for the first time, but I think I'll ask if he minds if I have another surgeon look at them, which I don't think he will.