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    Old 04-07-2007, 10:33 AM   #1
    hey19
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    Calcaneal Osteotomy Failure

    Having been diagnosed with posterior tibial tendon insuffiency, I underwent a "lateral column lengthening with calcaneal osteotomy, flexor digitorum longus tendon transfer and Achilles lengthening" on December 1, 2006. Now I'm having trouble at the osteotomy site and am wondering if anyone else has experienced similar trouble. My physician did not order MRI or Cat Scan testing preoperatively ... not such a good idea I guess.

     
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    Old 04-07-2007, 11:27 AM   #2
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    Re: Calcaneal Osteotomy Failure

    What kind of problems are you having? Did it not heal? I am scheduled to have this done in May.

     
    Old 04-07-2007, 12:08 PM   #3
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    Re: Calcaneal Osteotomy Failure

    My foot looks like it has collapsed.. it is deformed looking once again and I am flat footed almost to the state I was. The only difference in the looks is that the upper half of my foot is more straight. The site where the osteotomy was performed is verrrrry tender and looks like a huge indentation in my skin. I cannot walk properly -- worse than before surgery -- and my ankle feels very rigid. My surgeon never did a Cat Scan or MRI presurgically, so there is nothing to compare to. I finally had a Cat Scan in mid-March (surgery was December 1) after complaining of pain and this is what the report says (some of which I do understand, and some of which I don't.): "Impression: Postsurgical changes are present. Portions of the osteotomy site of the distal calcaneus is still visualized. The distal fragment appears to be displaced superiorly 5 to 7 mm and bone graft fragments are also seen displaced superiorly into portions of the tarsal sinus and anterior aspect of the talocalcaneal articulation as described. Bony bridging between the calcaneus and talus at this level is difficult to exclude on the basis of these images. Bones are osteopenic." I apparently have osteopenia -- never knew that since I had a bone density test done last June, which was normal. I also have lupus. There was no screw used during the osteotomy. I have a second appointment with my primary care physician scheduled this week to help me determine what doctor/physician to see next. Believe it or not, I am an extremely proactive person who just happened to trust toooooooooo much and perhaps not be proactive enough with my own health. Whatever you do, make sure you read, read, read, read...... talk to people..... ask questions.... I wish I'd discovered this board earlier. It is a wealth of information from real people who share their real-life experiences.



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    Originally Posted by wtwct View Post
    What kind of problems are you having? Did it not heal? I am scheduled to have this done in May.

     
    Old 04-07-2007, 08:31 PM   #4
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    Re: Calcaneal Osteotomy Failure

    are you having pain at the osteotomy site ?
    did he tell you it was completely fused ? or a delay in union ? what has he told you ?
    did your dr go over the CAT scan results with you ? what did he say ?
    if there is a delay in fusion and everything is still aligned the way he wanted it a bone stimulator may help with fusion. Also, Fosamax may be helpful. My Dr puts all of his patients on bone stimulators and Fosamax. Some people take longer to fuse, especially if they have underlying conditions such as Lupus.

     
    Old 04-08-2007, 06:26 AM   #5
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    Re: Calcaneal Osteotomy Failure

    Yes, definite pain at the osteotomy site.... also a very large indentation there in the skin -- whole area is painful and sensitive. I brought the Cat Scan films with me to my appointment and went to get the report on my own at a later date. Doc gave me a cortisone shot in the ankle during the visit where we were supposed to discuss the results and wrote me a prescription for more aggressive therapy. I later found out the radiologist had actually discussed the Cat Scan results with him prior to this visit... yet he did not discuss them at all with me. Doc never said a word about "fusion" only that it looked like things were healing... never mentioned "delay in union." X-rays in the beginning showed perfect alignment. Then I started PT. After a month I went back to the surgeon and the next set of x-rays showed things were no longer in alignment. He said that some amount of this is expected....I didn't believe it because the change was pretty drastic. I asked right in the beginning about my lupus causing any problems (I have a verrrrry mild case) but he said it was of no concern... I can't say I believe that either. The Cat Scan report says the osteotomy site shows "bone fragments." Does this mean the bone graft is coming apart? Do you happen to understand this?


    Quote:
    Originally Posted by snwtygr View Post
    are you having pain at the osteotomy site ?
    did he tell you it was completely fused ? or a delay in union ? what has he told you ?
    did your dr go over the CAT scan results with you ? what did he say ?
    if there is a delay in fusion and everything is still aligned the way he wanted it a bone stimulator may help with fusion. Also, Fosamax may be helpful. My Dr puts all of his patients on bone stimulators and Fosamax. Some people take longer to fuse, especially if they have underlying conditions such as Lupus.

     
    Old 04-08-2007, 12:13 PM   #6
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    Re: Calcaneal Osteotomy Failure

    hey19

    sorry don't know how to read your report. I think you definately should go to seek as many specialist as you can for more opions to see whether you can put the pictures together. Hopeful you get some valuable info. In my area, it's hard because none of docs wants to say anything negative if other doc has work on your foot. it's just sad. Don't listen to the doc's lame excuse. They always want to make you to believe everything's fine after they touch you. mine's too. very typical of them. they want to keep you in the dark so you don't know what they are doing to you esp. when they screw up then you won't challenge them. I think you should also be careful about cortison shot. I would not want any of the shot for myself. this is short term relief from immflamation and pain. guess effective way to stop the pain short time so that you don't complaint anymore. Many online scouces I went said this in the long term it would further weakening your tendon. to me, why chance it. I'd want to check on anything I don't feel comfortable with, esp. you mention the indentation. if local doc couldn't help, I'd go to as far as I can to get the best doc I could find. Some people go to the Mayo Clinic you may have to pay yourself, so what, that's your only feet and a peace of mind. well, it's just me. everybody is different. do anything you feel comfortable and don't wait too long. oh, meanwhile, work on yor general health, exercise (just don't do anything to cause pain to your surgery foot)and eat well (foods rich in anti-oxidants), to improve and boost your immune system. It can only help. I know doc won't tell you that they don't care your general health not their problem other than the foot, but we know our body functions as one whole unit. Hope you'll find some answers to your foot and keep us posted.

     
    Old 04-09-2007, 05:04 PM   #7
    hey19
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    Re: Calcaneal Osteotomy Failure

    Cindy... Thanks for answering. I hope somebody will try to help. I am going to see my primary care physician tomorrow to get some direction on what to do next. This is tough since I am a pretty physical person and cannot even go for a walk, let alone back to a gym. What happened to you? What medical trouble do you have with your foot?

    QUOTE=cindy777;2908865]hey19

    sorry don't know how to read your report. I think you definately should go to seek as many specialist as you can for more opions to see whether you can put the pictures together. Hopeful you get some valuable info. In my area, it's hard because none of docs wants to say anything negative if other doc has work on your foot. it's just sad. Don't listen to the doc's lame excuse. They always want to make you to believe everything's fine after they touch you. mine's too. very typical of them. they want to keep you in the dark so you don't know what they are doing to you esp. when they screw up then you won't challenge them. I think you should also be careful about cortison shot. I would not want any of the shot for myself. this is short term relief from immflamation and pain. guess effective way to stop the pain short time so that you don't complaint anymore. Many online scouces I went said this in the long term it would further weakening your tendon. to me, why chance it. I'd want to check on anything I don't feel comfortable with, esp. you mention the indentation. if local doc couldn't help, I'd go to as far as I can to get the best doc I could find. Some people go to the Mayo Clinic you may have to pay yourself, so what, that's your only feet and a peace of mind. well, it's just me. everybody is different. do anything you feel comfortable and don't wait too long. oh, meanwhile, work on yor general health, exercise (just don't do anything to cause pain to your surgery foot)and eat well (foods rich in anti-oxidants), to improve and boost your immune system. It can only help. I know doc won't tell you that they don't care your general health not their problem other than the foot, but we know our body functions as one whole unit. Hope you'll find some answers to your foot and keep us posted.[/QUOTE]

     
    Old 04-10-2007, 12:10 PM   #8
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    Re: Calcaneal Osteotomy Failure

    hey 19, I am sure you'll get help eventually. at least you have a family doc you can lean on. sorry couldn't be of any specific help. From what you mentioned, you have to get somebody happened to have the same condition and surgery and also knows what's going on; or, docs in that field. based on my experience, get the old experienced one.

    I envy all of you. I am sure you all get better physique than I do. I am a wimp that can only handle walking (normal slow pace) in my normal condition. can't do one sinlge pull up or push up, can't handle a lot of other physical condition. At least you get a very strong body to handle the physical stress on your body.

    I am new to the tendon problem and I think my problem is the smallest compared to most of yours. My problem before the surgery is that I had a coin size bruise on inside of my ankle with some dull pain not that bad but interupped my sleeping and after 1 months not getting better, it bothered me with the knowledge that it'll progress until to the point your foot will collapsed as you all know about. of course my current problem is bigger than that after the surgery which should not have happened, I can't walk much, foot is painful all the time that also wake me up often and make me a very light sleeper, nerve damage on the foot, I am very tired daily, can't eat or digest much, weak and sneeze. of course that's not my doc's version before the surgery which he so into for me. told me it's easy simple and the only chance i'd recover I definately had my tendon partially torn according to MRI. story changed after he cut my foot that my tendon was ok. he pretty much made a mistake (of course they never admit that). people don't do surgery in my stage (stage 1) to make it worse for nothing, it's insane. since he's got tons of visits from me (squeezed enough $$$ already) and he had no a clue how to fix me now, it's not his problem, it's the phychiatrist's or the OBGYN's (what the heck he's thinking?) because he said I have depression, the a**h**** just deserted me high and dry let me hang on there to figure out what happened and what to do now. I told myself f*** them all, I am the only one that I can depend if I want to walk again, I have to pick up the pieces one by one myself. well, that's my story, not a good one, sorry.

    I sure hope you get a better luck than me with your doc, hopeful, somebody like Rita's doc. Well, seemed Rita is very at peace with what happened and that helps too.

    Last edited by cindy777; 04-10-2007 at 12:28 PM.

     
    Old 04-25-2007, 04:44 PM   #9
    hey19
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    Re: Calcaneal Osteotomy Failure

    Thank you so much for the helpful tips. I will ask about the bone stimulators now that I know I have to have another surgery. I went to a new doctor and it seems the osteotomy is totally out of place; it's risen upwards and is causing all sorts of trouble, including a good amount of side-to-side mobility issues. The original surgeon told me nothing about the report other than it looked like "an outcropping of bone." He did not go over the results with me other than what I just told you. Can you believe that? I knew a few appointments prior that things were out of alignment and the doctor's response was that some of this was to be expected. I'm glad I've changed doctors. Again, thank you soooooooo much for the tip on the Fosomax!

    Quote:
    Originally Posted by snwtygr View Post
    are you having pain at the osteotomy site ?
    did he tell you it was completely fused ? or a delay in union ? what has he told you ?
    did your dr go over the CAT scan results with you ? what did he say ?
    if there is a delay in fusion and everything is still aligned the way he wanted it a bone stimulator may help with fusion. Also, Fosamax may be helpful. My Dr puts all of his patients on bone stimulators and Fosamax. Some people take longer to fuse, especially if they have underlying conditions such as Lupus.

     
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