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  • Ankle Instability

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    Old 07-23-2008, 11:03 AM   #1
    mgstars20
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    Ankle Instability

    Has anyone had a calcaneal osteotomy? I went to three ankle specialists for loose ligaments on the outside of my ankle, and they have recommended I have three things:

    calcaneal osteotomy (lateralizing. break heel bone, move over and put in screw).
    brostrum (tightening of ligaments?)
    parenium longus to brevus transfer

    I was totally down for some soft tissue repair, but not sure I want to mess with the shifting and breaking of a perfectly good heel bone.

    Does anyone have experience with any of this? I have an extremely loose ankle (well, two) and cannot play soccer any more, which is devastating to me. Although I can still run, I would like a better quality of life, but don't want to risk it all... help!

    Melissa

     
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    Old 07-23-2008, 12:27 PM   #2
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    Re: Ankle Instability

    Hi, Melissa, sorry you are dealing with all of this!

    Brostrum ligament repair and peroneal tendon work are pretty common procedures for lateral ankle problems. I haven't heard of anyone having a calcaneal osteotomy just for ankle instability, though.

    Just guessing here, I'm no doctor, just a veteran of ankle wars. Presumably the surgeon thinks your foot has some sort of structural problem that caused your ligament and tendon problems. If this is true, then repairing the soft tissues and not adjusting the bone could mean the problem comes back.

    Did all three surgeons recommend all three procedures? If these people are board-certified foot and ankle surgeons, and they are in agreement, I would have to say listen. If only one of them wants to mess with the heelbone, that's another matter.

     
    Old 07-24-2008, 12:42 PM   #3
    mgstars20
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    Re: Ankle Instability

    Hi there!

    Thanks for the reply!

    Yes, I have structural issues which is why they are recommending the osteotomy. Even if they do the soft tissue repair, there is a high chance it will fail because of my "mechanics", I will stretch it out again. So ligament tightening is a temporary solution I guess I would say.

    I am worried to get anything done, especially with the bones, because I currently have NO pain. I just roll my ankle all of the time, and I cannot play soccer which is devastating to me. But the only thing that would be worse, is if I couldn't run or exercise, which I feel I am risking by going into surgery.

    I just don't know what to do. Have you had an osteotomy or the tightening of ligaments before? Has anyone out there?

     
    Old 07-24-2008, 01:28 PM   #4
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    Re: Ankle Instability

    That's a tough question, whether to have surgery if you don't have pain.

    When ankle arthroscopy was recommended to me, I asked a lot of questions. Once I understood the procedure, risks, and benefits, not doing it never crossed my mind, because I did have pain, difficulty walking, and generally didn't have a normal life for someone who was 67, much less 27. (I had a good outcome, my only regret is not doing it sooner.)

    The problem is, if you are rolling the ankle all the time, you could be damaging cartilage and other structures. Repeated sprains don't hurt because the ligaments are already torn.

    It sounds like you are still unsure about this. I suggest you go for a fourth opinion, this time with someone who isn't a surgeon. A non-surgeon orthopedist, sports medicine guy, or your family doctor. The recovery from a procedure like this is long, and there's nothing wrong with taking a little extra time to decide.

    We have several people on the board now who've had ligament repair, you can use the search function to pull up posts about "Brostrom" or lateral ankle ligaments. Also, some people had calcaneal osteotomy as part of PTTD surgery (that's repair of a tendon on the inside of the ankle) so check out some of those threads as well.

     
    Old 07-25-2008, 10:59 AM   #5
    Gnocchi
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    Re: Ankle Instability

    Hi Melissa

    I had a brostrom and repair of ruptured peroneal tendon on my right leg in December. As far as the brostrom goes, I've lost a little range of movement, but nothing I wanted to do anyway (bending my foot inwards.) I used to trip on that foot all the time and that almost never happens now.

    I haven't read here or on any other sites of anyone having a bad experience after a brostrom, so maybe it's a pretty safe procedure? The recovery took quite a while though (as opposed to the peroneal tendon procedure which I just had on my right leg) and I wish I'd been more prepared for that

    Good luck with your foot!

     
    Old 07-25-2008, 05:09 PM   #6
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    Re: Ankle Instability

    I had a calcaneal osteotomy along with tendon transfer for PTT surgery. I had one large screw in the back of my heel but some people have two smaller ones. It took six weeks for the bone to fuse - some people take longer. I had my screw removed at six months because it bothered me. Moving the heel bone creates an arch so the tendon doesn't have to work to do it. Ask any questions you may have about it and I'll be happy to answer what I can. Welcome to the board!

     
    Old 07-26-2008, 09:04 PM   #7
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    Re: Ankle Instability

    hi there! thanks for the reply! yes i actually have a very high arch and hindfoot varus, so probably the opposite problem that you have. i need to take some of my arch out.

    i guess im wondering if you thought the surgery was worth it, if it was successful, how much pain you have now, post-op, etc. do you know what the risks are that the bones dont fuse?

     
    Old 07-26-2008, 10:18 PM   #8
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    Re: Ankle Instability

    I have read a LOT of postings on different foot forums as well as done a lot of online research. I have never heard of a calcaneal osteotomy (sliding) not fusing. It may happen but I've never heard of it personally. I would say the surgery is worth it because I probably wouldn't be able to walk if I hadn't had it. I have had some ongoing issues but the foot realignment worked out fine. I have an arch and my foot is perfectly straight. My issues are not related to the osteotomy. A year after PTT surgery I had peroneals repaired and a year later scar tissue impingement which required arthroscopy and now have some early degenerative changes causing joint problems. I'm sure you will be fine. My case is rather complex so don't judge success or failure by me :=) .

    Last edited by emmie54; 07-26-2008 at 10:20 PM.

     
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