Flatfoot reconstruction - What to expect in healing? - Foot Problems Message Board

Footjoy · 01-13-2008, 11:58 AM

Hi Everyone,
I am 5 days post surgery for flatfoot reconstruction. I am wondering about the timetable for healing and what others have experienced.
My foot problems started 10 years ago when I had an accessory navicular removed from my left foot. Almost immediately after recovery, my arch started to fall in. The podiatrist saw that the arch was falling and just offered orthotics as a solution. Orthotics did not help. So I just decided I would have to live with a fallen arch. This last year my foot got much worse. I was walking with a limp and had no ability to push off with my toes. A second podiatrist ordered an MRI and said I needed a talonavicular fusion. So then I went to see an orthopedic foot and ankle specialist. He wanted to do a sliding heel osteotomy, FDL transfer, and talonavicular fusion. I knew that the fusion would cause me to lose a lot of motion in my foot. So I went to a 3rd orthopedic who was younger (my neighbor suggested that a younger surgeon might have learned some new techniques that the older ortho didn't know about). The third Dr. said he tries to work around fusing in the major ankle area if at all possible. So I went with him. My surgery was 5 days ago. He did a heel osteotomy inserting a wedge of cadaver bone. Then a second heel cut to slide it over. Then a FDL transfer, reconstructed the spring ligament, loosened the gastrocnemius muscle, and fused the cuneiform-first metatarsal joint. Have any of you had any of these procedures? What was your healing process like? Should I try to wiggle my toes in the first two weeks?
Thanks for any advice on this long recovery!

sunny77 · 01-13-2008, 09:02 PM

Sounds like you've gone through a lot with different opinions and now you're on your way to a better foot! Last May I had an Evans osteotomy (the bone graft/wedge) and posterior tibial tendon repair. I'll be having the same procedures done on my other foot in Feb.

The timeline I had was 2 wks in a splint, 4 wks in a cast and then 4 wks in a walking boot. The first 6 wks were NWB and then WB as tolerated the last 4 (I used a crutch for less than a week, then was walking on my own in the boot, but that varies for everyone). PT started around 6 wks and lasted 2.5 months. I started "running" again around 4 months post-op, though that didn't last long due to my other foot going downhill. I took pain meds regularly for a few months, but the dosage and frequencey went down significantly. Elevating as much as possible, putting ice on the ankle/foot and behind the knee is a big help. I know if I was up too much, my toes turned blue and started throbbing and the swelling increased. Wiggling the toes is good to help with circulation...unless you were told not to, it probably would be good to do some of.

I used a knee scooter (Turning Leg Caddy) and this was a lifesaver. I rented it from a medical equipment company and my insurance paid a majority of it. I am going to get one for this second surgery too. If you don't have a shower cast cover, you might want to ask your clinic about one or get one online. The recovery is long and hard...stamina goes down the tubes and it gets boring...but it does get better and the results are worth it! There are a ton of people who have had similar procedures and there is a good thread called posterior tibial tendon surgery somewhere on this board....lots of good info there. Feel free to post more thoughts and questions....it's helpful knowing what others have gone through and that you're where you should be.

Footjoy · 01-14-2008, 08:27 AM

Sunny77,
Thanks so much for your response. This is the first time I have ever posted on the internet! I have located a turning leg caddy at a local durable medical company. I think it will be a big help. Did your doctor take x-rays at each of your office visits? Are they able to tell if the bone is fusing properly? I have read of some people who had certain "hot spots" in their fusions where the bone remained soft. When you started physical therapy did you feel a lot of stretching in the posterior tibial tendon and was it very painful?
I am encouraged to know that I can actually wiggle my toes. With a FDL tendon transfer I didn't know if it would decrease movement in the smaller toes where the FDL tendon came from.
Were you given any antibiotics to take at home? I received some IV ones at the hospital but didn't bring any oral antibiotics home with me.
Thanks again

lyksbmx · 01-14-2008, 12:12 PM

I had reconstruction surgery on November 2nd...so I'm about 10 weeks post op. I FINALLY got my fiberglass cast off this morning. For the last 4 weeks it's been a "walking cast"...just working up to full weight bearing. Now I'm in a walking boot for another 4 weeks. Everything looked great this morning. Everything feels great now. I could wiggle my toes after surgery also...but now I still can't curl them. Not sure if it's from the tendon they used, but I guess curling my toes isn't a big deal if everything else stays this great. Good luck on your recovery! Make sure to eat right, and try to get some circulation down there! I had a weight bench at home and started lifting some weights about a month in. I also started taking calcium pills after about a month. This morning he said I've been doing a great job and all my bones have healed already. Anyway, like Sunny said there are a ton of other posts on here about flatfoot reconstruction and they are pretty helpful. Good luck!

-Steven

Footjoy · 01-14-2008, 03:33 PM

Steven,
Thanks for responding. It sounds like you have really healthy, strong bones!
I can't tell if I can curl my toes because the splint comes out too far.
I'm 7 days post surgery. This afternoon I tipped my turning leg caddy and accidently put weight on my foot. I really hope that I didn't damage anything.
What procedures did you have done on your foot? Has this been a longstanding flatfoot or did you have some kind of trauma to your foot? Do you still need pain medication?
I go back to the Dr. on the 24th to get the stitches out and get a hard cast.
I'll bet you are glad you're as far along as you are!
Susan (Footjoy)