Ready for Tendon Transfer/Calcaneal Osteotomy Surgery - Foot Problems Message Board

hurts2walk · 07-24-2008, 10:54 PM

OK - here goes my first post!

History: About 7 years ago I was diagnosed with Tarsal Tunnel (like carpal tunnel - only in the feet). I have flat feet and severe pronation. The ortho told me that the pronation was trapping the nerves in my ankle. I had nerve release surgery on my right foot. After the long recovery I had about 70% improvement. Since then I have had increasing foot pain in both feet with the left one slightly worse. Two years ago I went back to the Dr. for knee pain. I had custom orthodics made and PT. The knee pain was casued from the flat feet and my gait. I complained about the feet hurting again but I guess I did not push hard enough for any "real" help. My feet have gotten severely worse and I kept putting off going back to the Dr. just assuming it was the Tarsal Tunnel. Well, this summer I decided to ask to be referrred to a foot/ankle specialist. New othodics were made and an MRI was scheduled. The MRI showed complete rupture of the posterior tibialis tendon in BOTH feet. Well....that explains the pain huh? I was shocked and sad that I pretty much walked on those feet all those years causing more damage with every step. Now my only option is surgery of course. Tendon transfer and calcaneal osteotomy in both feet. My google searches have landed me here and boy am I ever glad. I have learned soooo much already! I have yet to schedule the surgery though.......trying to get things in order....taking the time off work etc. I am so nervous but on the other hand I cannot wait to see how much different my life will become after recovery. I am so limited in what I can do now....my quality of life has diminished so dramically in the last few years. It is depressing. I am gearing up for a LONG road ahead.....having 2 surgeries. I will be visiting this site daily and asking questions and reading anything I can about this surgery and recovery. Thanks to all in advance!

kristian85 · 07-25-2008, 09:24 AM

hey

Man that really sucks about your feet. Doctors don't always know what they are talking about... I've run into my fair share of that one. I go for surgery on the 5th for a problematic accessory navicular but depending on how it goes thay may also need to do a tendon transfer. I don't know much about surgery.. never had one before... but my Dr. said if he fixes the tendons then it will be about 2 months for recovery and about another month in physio and all would be as good as new.

SO hopefully your surgery goes well and your back on your feet soon

sunny77 · 07-25-2008, 01:10 PM

Welcome to the board...wish it was for something more "fun" than this!! I see you're also from MN...are you in the Twin Cities area? If so, who is your dr? I'm in the TC and go to Summit Ortho, they have a foot/ankle orthopedist who is awesome...did a great job!

I have had PTTD in both of my feet and had the left fixed in May 07 and the right in Feb 08. My PTT were not ruptured, "only" torn, so I was able to have them repaired (no tendon transfer). I also had an Evans osteotomy in both, which is where they put a bone graft in on the outer part of the foot. Now the tendon serves more as a shock absorber than anything; the bony procedures created an arch.

Will you be having a sliding calcaneal osteotomy (cut heel bone, slide it over, put pins in) or an Evans? Have you been given the timeline and told what to expect? Are you scheduled yet?

The timeline I had was 2 wks in a splint, then stitches out and cast or boot on for 4 wks (so 6 wks non-weightbearing), then a boot for 4 wks, bearing weight as tolerated. PT started at 6 wks and lasted about 3 months (2x/wk). I am about 5.5 months post-op on my right foot and just returned to jogging, yoga, the gym, 2 wks ago. With my first foot, I was back at it around 4 months post-op, very briefly since my "good" foot went bad. I took pain meds for longer the first time, less the second...it varies for everyone. Icing, elevating are both key. Having a shower chair and handheld shower head as well as an Aquashield or other cast cover are also good to have. One of the best inventions out there for both times around was the Turning Leg Caddy (TLC...also other brands like Roller-Aid, Roll-A-Bout, etc.), which is a knee scooter. It allowed me to go shopping, walk my dog, and generally stay more independent than using crutches. I was able to return to work around 3 wks post-op both times and I do have a job requiring me to be in facilities, homes, hospitals, etc. and to be in my car a lot. I was tired and took a nap most days, but was able to do it (or I'd mentally have gone nuts!). Others take a longer time away...varies and depends on what your dr says, how you're feeling.

Anyway, hopefully that's helped answer a few questions you might have had. Feel free to ask away, many people on this board have had PTTD surgeries and can offer ideas/support.

hurts2walk · 07-25-2008, 09:39 PM

Sunny77

Thanks for the info on your surgery/recovery. Can you tell me what PT was like?

I am seeing Dr. Felton of Twin Cities Foot and Ankle Clinic. I have yet to schedule the surgery. I will be calling Dr. Felton with a few more questions about the calcaneal osteotomy but I believe it is the "sliding" procedure. I left his office a few weeks ago in shock as I was expecting to hear more about the Tarsal Tunnel and never expected the RUPTURE talk! I also had plantar fascitis on my mind and now I am reading some about the "trio" of TT, PF and PTTD. Interesting.

sunny77 · 07-25-2008, 10:07 PM

Hi hurts2walk,
I have heard of the clinic you're going to...they're more in Mpls, right? I imagine it was quite a shock to learn that both are in the shape they are! I know I was in that place with my first one too, even though I'd been told it was possibly going to happen. I found it really helpful to do some research, write down questions and then talk with my dr about them; he was great about answering everything since I hadn't absorbed much during the visit.

You may not have thought this far ahead, but if/when you have surgery, they usually use general anesthesia. I requested a popliteal block, which is when they do a block from behind the knee and it numbs you all the way down to your foot. It lasts for 12-36 hrs (depending on how much they put in there) and is wonderful after surgery for pain relief! I had requested it the first time and they didn't have an anesthesiologist who could do it (knew how), but the second time they did and it saved me from having to stay overnight in the hospital.

PT...at first, she gently stretched and massaged it. Within a week or two, I was doing some stationary biking and worked up to doing some light exercises. It's about getting range of motion back in the beginning and then strengthening as time goes on. I usually iced with a system called Game Ready (applies pressure and cold) at the end of the session. The first time around, I did use the whirlpool to help loosen things up, but not the second time. It does hurt at times, but that starts to get better over time. I often made sure to take a pain pill before the earlier sessions, as it would get pretty sore. I did 24 sessions on each foot, so about 3 months, and had exercises to do at home. I think of the first 6 wks (when NWB) as kind of a "relaxing" stage and the PT part as an active "working" phase.

Sunny