Good evening, everyone. Almost a year ago, I slipped and fell, dislocating my knee. At the same time, I severed my peroneal nerve, and have suffered with foot drop for the past year. My only function in my foot is to push it downward and to move it inward, on the side of my big toe. I've heard of anterior tibial tendon transfer surgery, which may help. However, I've also heard of some negatives.
These negatives would consist of further weakening of the ankle, and the possibility of the surgery being unsuccessful, and being left with only one functional tendon; that being the Achilles.
If any one has had this type of surgery, or is knowledgeable in this surgery, please respond with advice before I attempt to proceed with having it done.
Good evening, everyone. Almost a year ago, I slipped and fell, dislocating my knee. At the same time, I severed my peroneal nerve, and have suffered with foot drop for the past year. My only function in my foot is to push it downward and to move it inward, on the side of my big toe. I've heard of anterior tibial tendon transfer surgery, which may help. However, I've also heard of some negatives.
These negatives would consist of further weakening of the ankle, and the possibility of the surgery being unsuccessful, and being left with only one functional tendon; that being the Achilles.
If any one has had this type of surgery, or is knowledgeable in this surgery, please respond with advice before I attempt to proceed with having it done.
Dear Erinesque,
I read your report and it sounds exactly like what happened to me... May2009 slipped and fell, dislocated my right knee and riped 2 ligaments.. and my peroneal nerve was streched. Had knee reconstruction and nerve realese in June. Hoped for nerve recovery but until now the EMG show no recovery at all.. considering tendon transfer but also with the same doubts as you.
Well, I had the surgery, and I was mistaken: it's actually posterior tibial tendon transfer that was done. I had the surgery done on April 7, 2010. I have to be in a cast now for six weeks. I'm not able to post attachements, otherwise I'd upload a photo of my leg in its cast at the moment. I won't know if the surgery is successful until after I start physical therapy, in five more weeks.
Today is Thursday, April 29,2010. It has been twenty-two days from surgery. I was instructed by the doctor to take my foot out of the air cast that he has had me in, and to try to "re-educate" the tendon by trying to move my foot. He was not sure that this would even work, because we're taking a tendon out of phase and transferring it to a place where it has to function completely differently.
Well, I've tried many times throughout the last 3 weeks, to no success, but tonight, at around 11 pm, I was able to move the foot up a little bit. It was a little jerky and a very small movement, but it was definitely voluntary! I'm terribly excited, and working hard on not over-doing it. It seems, and this is an early inkling, that the surgery was successful. I'll keep everyone apprised.
Last edited by Erinesque; 04-30-2010 at 04:24 AM.
Reason: to give more information than I previously had.
After all this time I guess to see you foot move again is something amazing!! Work hard in therapy!! I wish you all the best!!!
I had my EMG done last Tuesday 26th of April 2010, and...guess what??
I got a signal on my muscle. I had a small, very small, but had a signal.. after almost a year from my acident and exactly 10months after my surgery I had some recovery. The doctors aren-t sure if this late recovery will mean anything. I mean if it will be enough to regain movement on my foot but they think it is worth the wait. Going to repeat the exam in 3/4 months to see if there was any evolution.
To tell the truth, I almost cried with happiness when I saw my foot move again voluntarily. The doctor had tried to give me realistic expectations, saying that because my injury to the nerve was dense, and I had no communication going to many of the tendons down there, that the surgery may not work at all. I went into it thinking that if it does work, which I wasn't totally expecting, it'd be great, but if it doesn't, then I'm really no worse off than I am right now. After being this skeptical, the sight of movement was incredible!!! I have my next appointment with the doctor on Tuesday, so I'll get to show him then! Won't he be surprised!
I can´t imagine your happiness to see the foot actually move!!! I dream of that!!
Work hard in theraphy it works!! I still do it 3x a week and try to work harder every week!
I wish you all the best!! Keep me posted!
André
Quote:
Originally Posted by Erinesque
To tell the truth, I almost cried with happiness when I saw my foot move again voluntarily. The doctor had tried to give me realistic expectations, saying that because my injury to the nerve was dense, and I had no communication going to many of the tendons down there, that the surgery may not work at all. I went into it thinking that if it does work, which I wasn't totally expecting, it'd be great, but if it doesn't, then I'm really no worse off than I am right now. After being this skeptical, the sight of movement was incredible!!! I have my next appointment with the doctor on Tuesday, so I'll get to show him then! Won't he be surprised!
how is your reeducation going? able to move the foot up?
on my side I still have hope, i haven't done any EMG since the last one but i can (and so does the doctor so it means i am not imagining) feel clearly a muscle contraction and my foot moves a little little bit. when i do it sideways i can see it move a bit. since the muscle didn t work for such a long time it attrocfiated and I now do electric stimulation directly to the muscle at home (with a machine that every tme i use it remembers me of those tvshop ad at 3am that you connect some wires and you become mr ironman! )
I still have hope this will improve enough for me to stop using the foot up i use everyday!
My doctor actually told me that these things take some years the important is that it keeps getting better, as long as there is evolution no matter how small it is, there is hope!
had the surgery on Feb 7th, 2011 at Mayo clinic in Rochester. Surgeon is Norm Turner. Had the cast for 8 weeks and it came off 3 days ago. I could immediately lift my foot. Dr, Turner said not everyone can do that right away. It has ben 3 days since cast off and i am in an air cast. I can walk with a cane but very slowly. I use a walker at night without the cast and can put full weight on my foot. Tips: lifting foot easiest if you lay on your side to exercise it. Also do not try lifting toe first since your toes will not work that way, you are actually lifting at the point where the tendon is attached, hold your foot in your hand and feel the tendon and push foot against your hand.
Now that some time has passed, how are you all progressing? I am due to have a similar surgery to correct drop foot subsequent to synovial sarcoma, radiation, and graft surgery back in 1994. Over the past 6 to 7 years I've noticed progressive weakness in my left foot and now have to wear a brace to correct the drop foot. At 52 years of age, I feel I need to seek help to correct this condition. I've been evaluated at Yale but no one wanted to be bothered, it seems. I did find a surgeon in New Jersey who feels he can help me. I'm still undergoing some tests to check the anatomy since I've already had some surgery in that area. This tendon transfer news was good news to me and I was checking the internet for anyone who has had this surgery. I hope you are all well and recuperating better than expected.
Had the surgery in february at the Mayo clinic in rochester, mn by Dr. Norm Turner. I am currently walking without an AFO. still have a limp but working on that. I find that walking on a treadmill at my health club at the slowest pace and using music to find a beat to walk to has me walking normally. I think at this point it is just training my brain to walk without the limp. I do still have some swelling which causes some pain by the end of the day but dr. turner said the swelling could take a year to fully disappear.
I am also curious to hear updates on how you all are doing. I tore my tendon from a 10 foot fall from an airline catering truck. I had an MRI and the Orthopedic Surgeon put me in an air cast, gave me 2 months of PT and I got Orthotics for my shoes. Nothing seemed to help, and I seemed to be getting progressively worse. I got a second opinion from a top notch Orthopedic Surgeon at The Cleveland Clinic, and he says that I have stage 3 Anterior Tibial Tendonitis. He says that I am an excellent candidate for tendon transfer surgery. The Dr also says that he has had allot of success, and I should be back to normal after recovery. I am scared and worried about the long recovery, but I will be glad to get it over with.
Do you have any advice for me. Is this surgery worth all the pain and recovery??
It will be a year in february since I had the tendon transfer surgery. It is a long recover, the first 2 months of non-weightbearing is the worst but now I am so glad I had the surgery. My foot works very well. swelling lasted until about august when I wised up and got some compression socks (dr. scholls) and then had a few sessions of physical therapy to increase the range of motion. I still have pain from the healing which is normal even now but it is managable with a couple advil every day. I can walk about a mile now even over uneven terrain. One thing the doc will certainly tell you is that you will not be able to pick up your toes so walking barefoot is difficult but I wear socks and sandals around the house and am fine.
Does anyone know good exercises for post surgery physical therapy or what to expect? Not able to find much information and my surgeon has not provided alot of info.
Anterior Tibialis Surgery transfer tendon from toe.
Surgery in Sept 2011. Lots of swelling after put in cast. 8 weeks in cast. Still alot of swelling. Boot for 6 weeks. Feeling coming back and can move foot more than before, but not as much.
What exercises should I do or not do?
How do you know what the limitations are or max use? (Don't want to damage anything that has been repaired)
How long before normal activity is resumed?
What will I not be able to do permanently?
I had the surgery in february at the mayo clinic. my doctor started me on physical therapy in June, not before then because it needs a lot of time to heal. the swelling can last several months.
I'm not sure if you were referring to me about my Orthopedic Surgeon at the Cleveland Clinic, but his name is Dr. Alan Davis. I was referred to him by my Physical Therapist when I was seeking a second opinion. Dr. Davis is well known on the West Side of Cleveland, and he is top rated according to my PCP and several people that I asked about him.
I am scheduled for tendon transfer surgery in two weeks, Friday the 13th of January. I am a little scared and really dreading the LONG recovery process. I keep telling myself that I will never start to heal unless I get the surgery. I tore my Anterior Tibial Tendon when I fell 10 feet out of an airline catering truck while it was still raised to the airplane.
I know that I have allot of pain in my future, but I am tired of all the pain and limitations I have from my injury. Please tell me that this will all be worth it!
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