Triple Arthrodesis and Achillies Lengthing Surgery

Iowagirl · 09-11-2007, 12:08 PM

Hi there. I finally got my surgery date for Sept 17th. I'll be having a triple arthrodesis and achilles lengthening procedure done,( total reconstruction and bone fusing)My Dr will be using a fixator (halo type apparatus) versus the cast for the first 4 to 6 weeks.He said he preferred this to the cast and would help the bones to fuse and heal faster. I'm beginning to get nervous about the whole thing but know this is the right thing to do. I've been dealing with this since March and glad that I'm finally going to have it fixed. Has anyone had a fixator and how painful is it going to be? I will be in the hospital for 2 days. He told me I will be off work at least until Feb of 2008 and even then I may not be able to continue working there. ( I stand and do a lot of walking at my job) He told me I should consider a sit down job in the future. Anyway would like some feedback from anyone who would like to share. Thanks

debincalif · 09-11-2007, 01:22 PM

Hi there,

I don't know anything about the procedure you're having done, but I thought I would throw in my two cents' worth about returning to work.

In mid-March I had my posterior tibial tendon repaired along with an Evans calcaneal osteotomy (cut my heel bone and put in a wedge-shaped bone graft). I was in a rigid cast for 4 weeks and a boot (still total non weight bearing) for 5 more weeks. I began putting weight on the foot and going to physical therapy at about 10 weeks post-op.

I am still off of work, and it's looking like I won't be able to return to my regular work - I stand & walk on a cement floor 8+ hours per day. Right now, at almost 6 months post-op I can only tollerate about an hour of walking and/or standing and then I'm just DONE. My doctor did tell me that it will take 9 months to a year before I will see the final results of the surgery and be at 100% capacity, so obviously I've still got a ways to go.

In light of all of this, I'm searching for a new job which will allow me to be off of my feet much more than my current job does. This may be what you'll need to consider as well, but again, everyone is different and you may be able to tollerate more time on your feet. You won't really know until you're several months post-op.

Good luck to you, and keep us posted.
Deb

relteach · 09-11-2007, 07:34 PM

I can't speak to the procedure, but returning to a job with alot of standing when your foot has been through alot of trauma may prove somewhat difficult. It seems your doc has tried to prepare you for it. I did not have surgery, but am recovering from a broken 5th metatarsal--it has been almost 7 months and the break is still not completely healed. I have learned that no matter how much time docs may project the healing process to be, your body does what it wants to. Feet tend to heal more slowly due to some areas of limited circulation. I am back to work (as a teacher) where I stand, but I have had to adjust how I do things and where I go in my building. Things are slowly getting back to what they were in February. Be prepared to do whatever your doc tells you to the letter. My doc has told me that I have been a model patient, but still complete healing is elusive at this time. While you recover, take the time, relax and learn a new hobby, read some books and see some videos. Hope all goes well with surgery. Be sure to update here on your progress!

sunny77 · 09-13-2007, 12:45 AM

Iowagirl,
I can't speak to your particular surgery, though I do have a colleague who had the same procedure (no halo though) and is doing quite well now. Of course, her job is a sit down kind, so that helps.

I imagine this is a tough week for you, as the surgery is looming out there. As if you don't have anything else to do...these are a few suggestions. Before my surgery, I went to the store to stock up on bulkier/heavier things (ie, bottled H2O, soda, dog food, TP) as well as frozen/easy to eat things, knowing that it would be hard for me to manage those in the store and getting them from my car to my house while in a cast/NWB. If you haven't gotten your handicapped placard, it's much easier to do it ahead of time. My dr didn't sign the form until the morning of surgery, so I couldn't get mine until the next day, on the way home from the hospital...and I was painful then, but needed it.

Anyway...good luck with everything! Update us with how it all goes...it's a tough surgery, but so worth it (eventually).
Krista

snwtygr · 09-13-2007, 08:00 PM

Hi - I too had the triple and achilles tendon lengthening with the external fixator - both feet. It sounds like you understand the complexity of the surgery and the recovery and that's a big step ! I had the second foot done a month after the frame was removed from the 1st foot. I had 10 wires through my leg and foot. Be sure to follow the surgeons directions: clean the pin sites as directed, weight bear as directed as well. One of the advantages of the ex fx is that you can weight bear ALOT sooner than conventional surgery. In fact if you don't bear weight as he allows you the fusion will be delayed and healing will be slower. My doctor put me on Fosamax and prescribed a bone stimulator. The wires look alot more painful than they really are. After the initial post op period you hardly feel where the wires go through the skin. At times the skin can get irritated around the wire especially after cleaning. My Dr told me to clean around the wires with alcohol. If your surgeon recommeds alcohol to clean with, one thing that he told me to do was to get a spray bottle and spray the alcohol around the wires and gently clean with a gauze pad. Some people use cotton but I found that the little cotton fibers would get caught around the holes and cause more irritation and possible contamination. I would recommend a chair to sit on for the shower and/or a small stool to rest your foot on. For leaving the house I had a pillow case that I covered the frame with. I ended up finding a pillowcase with a zipper on the end that was helpful - it stayed in place better. I started physical therapy a week after the surgery and kept going through the whole recovery period for both feet. You literally have to learn how to walk all over again. The changes I see and feel now are completely amazing and I thank God every day that I found a great surgeon and that he specializes in ex fx. It is a great way to go. I also recommend before and after pictures. Have someone take a picture of you standing front, back and the side with your inner arch collapsed and you will be amazed at the final result. Also, I found with my second surgery because my first leg was still weak and I had an ex fx on the other I started using a walker for that surgery and I had much better balance and felt safer than when I had the crutches. As far as the final result and standing for long periods of time - I can stand and walk distances that people without foot problems can do. I just went to a baseball game - I walked 6 blocks to the stadium and stood the ENTIRE game in the bleachers and just had mild soreness. I am getting my body back in shape and plan to run a 5 K by the end of the year. I am also leaving my temporary desk job to go back to my career in a busy ICU. I haven't lost balance on uneven ground either like alot of people said I would. I know that not everyone has such a great outcome. My Dr from the beginning was optimistic about my prognosis and although I was fearful I was comfortable with his skill and judgement. I DID have a bumpy road but the ultimate result is priceless. Please keep us posted and if you have more questions before surgery or during recovery just ask !