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MonktonGreen 02-23-2009 06:50 PM

Having Brostrom Procedure in a week - what should I expect?
I am having a Brostrom procedure in one week and I am starting to feel a bit nervous! I have had chronic ankle instability most of my active life, and eventually seriously sprained it with a snap crackle pop! about a year and a half ago. I finally went to the Dr a year after the accident and, after holding my foot in his hand for what seemed like a nano-second, he immediately told me I needed surgery. He explained that he would use a cadaver ligament to help reconnect what still remains of my own ligaments. Other posts on this site haven't mentioned this as part of the procedure and I'm curious if I am having a modified procedure. I have multiple-joint hyper-mobility and I wonder if this is part of the reason for the use of the cadaver ligament. Any thoughts? My friends keep laughing at me and referring to me as "Zombie Foot" :eek:

Beyond the surgery basics, I am mostly concerned about my recovery time and managing my pain. I have never taken pain killers in my life and only take Ibubrofen when pressed. Are there any methods of pain management other than Vicodin and others like it?


janewhite1 02-25-2009 07:22 PM

Re: Having Brostrom Procedure in a week - what should I expect?
Hi, MonktonGreen, welcome to the foot board. Sorry I haven't answered you before now.

If he is using a cadaver tendon, that might be closer to a Christman-Snook surgery. Brostrum is usually repairing the existing ligaments. He might be using the donor tissue due to your hypermobility, or maybe your ligaments are just too badly damaged.

Right after the surgery, you will be in a half-shell type cast called a surgical splint. It allows room for swelling. For at least the first week, you want to have your foot propped way up above your head all day and all night. It will reduce the swelling and also your pain. Putting an ice pack on top of the cast (wrap it to prevent leaks!) and one behind the knee can also help. These, plus friends and good TV, are the best non-drug pain management techniques.

You will then be in a regular hard cast for a few weeks, and non weight bearing in a removable boot for a few weeks after that. Then, you will gradually return to walking. There will be physical therapy. Work hard.

The prescription painkillers: Take them. Trust me, take them. At least for the first couple days, take them on schedule whether you think you need them or not. It's much easier to keep the pain under control than wait until it becomes unbearable and then try to bring it down. Do not be afraid of addiction, despite the media, addiction in a person with no history of addiction who takes them as prescribed when really needed is very rare.

Make sure that you have food in your house. You will be on crutches, and it will be very uncomfortable to be vertical, even for a minute or two. TV dinners or premade foods are your friends.

Check the house. Can you get from bed to couch to fridge to bathroom on crutches? Remove any furniture in the way. Throw any throw rugs in the closet so they don't trip you.

Will you be home alone? It would be good to have someone around at least part of the day for the first week or so.

Look up cast covers for showering and something called a knee scooter. You might also want a shower chair.

WorldWalker 02-26-2009 11:10 AM

Re: Having Brostrom Procedure in a week - what should I expect?
I totally support the suggestions Jane has given because I've found them very important in trying to function. Roller Aid has been my main use around the house which seems to give me more time and freedom than my crutches.

As for "Zombie foot" My class was reading Frankenstein and I felt it spooky & ironic timing due to my foot having 5 incisions and who knows how many stitches and staples. However I've been sensitive lately to the jokes from friends but I must admit they're kinda obvious and easy to point out.

In regards to the pain killer thing I also had the addiction worry. What my doctor said to me is that she only gives me a weeks worth at a time to keep my progress monitored so that doesn't happen. I find it helps to be on oxcycodene, but my surgery is different so go with what's best for you and keep ahead of the pain.

I'm sorry I couldn't give more on the surgery, but hang in there.

K_Lana 02-27-2009 06:05 AM

Re: Having Brostrom Procedure in a week - what should I expect?
Hey there. I've been through 2 Brostroms. The last one I was told I'd have a cadaver ligament as well. THe procedure for that part was called a Colville procedure. But, it turns out my dr. did something else instead, and used part of the sheath from my fibula to recreate ligaments. But they still did the Brostrom, etc. So I used my own tissue instead of a cadaver, but they had to make ligaments from it just the same.

All dr.s are different in terms of recovery. I had a different dr. for both Brostroms. My second Brostrom was along with a more serious OATS procedure so my recovery has been a bit different this time. But, both times I started off with a temp splint or cast for about 2 weeks. Then that gets changed out for a regular cast (my second dr. sometimes does a boot instead) and then the hard cast for 4-6 more weeks and then a brace or boot after that. Total time on crutches is anywhere from 8-12 weeks depending on how aggressive your dr. is.
At 3 mos post op you are still in quite a bit of pain. By 4 mos post op you start to feel much more normal. By 6 mos I was pretty much good to go.

I didn't have much pain from my Brostrom at all and never took anything more than motrin for it. The hardest part was the wait to get back to regular activity.

MonktonGreen 02-28-2009 02:26 PM

Re: Having Brostrom Procedure in a week - what should I expect?
Thanks for the input - I did get some more info from my Dr which has put me a bit more at ease. I'm mostly worried about being gonzo from the painkillers and saying highly inappropriate things to the wrong people! Along the lines of "in vino veritas" - truth serum! I am a very active outdoorsy person and I hate the idea of being confined to the indoors and being on crutches. I know I will be glad I have had this procedure done by the time July rolls around, it's just going to be tough these next few weeks. Thankfully I'll be staying with my mother for the week after surgery so I won't have to worry about looking after myself in terms of cooking (although I plan on stocking up on instant foods as well as comfort foods - bring on the Oreos). My parents' house has a downstairs shower and I think there's a shower chair from when my stepfather had back surgery a few years ago.

Just trying to go down the check list of things to do and get beforehand. I got a pair of crutches from a friend. I need to buy some bags of frozen peas. I just treated myself to a new pair of sweatpants - I figure I'll be wearing lots of "comfort" clothes while I'm on house arrest! I've also got some TV shows on DVD - I figure I might have the attention span to watch half an hour of "The Office" even if I'm on narcotic pain medication. Am I missing anything??

Thanks again for the advice - I head into surgery at 6:50am Monday morning...

Hollywood48 03-14-2009 01:57 AM

Re: Having Brostrom Procedure in a week - what should I expect?
Monkton-How are you doing since your surgery? How is your ankle feeling? The suggestions you were given by the other posters were right on target. I have had a Brostrom procedure on my L ankle from repetitive sprains and instability. I hope you are taking your pain meds. You won't get hooked when you take them as prescribed. They can be your best friend. I hope you are getting around okay. Is this your first time on crutches? if so, how's it going?

I guess the only other thing I have left to add is move those toes. Keep wiggling them and trying to point them up and down. I know this sounds strange, but it's the only thing you can move while you are casted. I didn't do this much and now subsequently, every sprain I have had since then, I have ridiculously stiff and painful toes.

Let us know how you are doing and where you are in the recovery process!

MonktonGreen 03-15-2009 01:37 PM

Re: Having Brostrom Procedure in a week - what should I expect?
So recovery has been great so far AND they didn't have to use any zombie parts in the surgery! I had a whopper of a partial cast that was fiberglass splints with bandaging over it -so heavy! I took the lowest dose of the Percocet along with Vistral for the nausea and made sure to set alarms to take them in the middle of the night. After 5 days I scaled back the Percocets and am now just taking 600mg of Ibuprofen every 6 hours - totally pain free! I basically stayed on the couch at my parents for 9 days with the foot elevated about 90% of the time - and yes - the Dr. told me to wiggle my toes a lot!

On the 10th day I had the cast removed and got a walking cast booty. I used the crutches for a day or two but the Dr. told me to go fully weight bearing as pain allowed. I have been cruising now for a few days - so liberating! I also have some exercises to do for my puny shriveled calf muscles so the leg doesn't turn into total twig! I stay in the boot for 4 weeks and then I think I'm supposed to get a cloth brace for another 6 weeks.

So far, so good!! :bouncing:

ZenVegas 06-11-2009 12:15 PM

Re: Having Brostrom Procedure in a week - what should I expect?
Hi, I just had a modified brostrom ligament repair on May 11th, I also had arthroscopy and a plate and 7 screws removed from my fibula. I was in a splint for 2 weeks and then a cast for 3 more weeks. I'm hoping to get out of the cast. I don't think I need the brostrom repair. My ankle was SLIGHTLY loose. I don't want to have anymore problems with my ankle and my job requires me to be on my feet a lot. How long do you the recovery will be? When will I be able to run and exercise again. I used to walk and run with the screws and I even did training with a trainer for 3 years prior. I just suddenly started having pain after wearing high heels for the job but I don't think I sprained my ankle. I think it was loose cartilige. Should I redo this procedure and have him put the ligaments back? Is it possible?

ZenVegas 06-11-2009 12:22 PM

Don't know what to expect
Hi I just had a Modified Brostrom repair on May 11th. I also had an arthroscopy and a plate and 7 screws removed from my left ankle. I'm a bit worried. I'm still in a cast and it's been 5 weeks. My foot really aches and I have no idea when I will feel better. I wanted to ask you how your ankle is feeling. Does it feel really tight or do you feel that it's just right now?
I honestly don't think I needed the Brostrom repair because I never sprained my ankle after the plate and 7 screws were put in 10 years ago. I just suddenly started having pain after wearing high heels which I need to wear for my job. Please tell me more about your experience. I'd love to learn more.
I know everyone is different but I'm hoping to walk soon. Thanks.

Bigdog Two 06-11-2009 12:50 PM

Re: Having Brostrom Procedure in a week - what should I expect?
My ankle was really loose. I used to twist it all the time. Ended up with chronic pain, cartilage damage, torn tendon. Had modified brostrom 4.5 years ago with some tendon repair and some of my tibia was also shaved off and some bone spurs removed and the joint generally cleaned up.

I am very glad I did it. I still have pain, but not as bad as before the surgery and I don't twist it/sprain it anymore.

Its not back to "normal" and never will be. Its a "new" normal. I limp sometimes and it really hurts in the morning.

But - its stable. Since my surgery I've run a marathon, have done about 15 triathlons, many long bike rides, etc.

ZenVegas 06-12-2009 08:46 AM

Re: Having Brostrom Procedure in a week - what should I expect?
Thanks so much for your reply. I really appreciate it. I just hope I don't have anymore pain. Well, I haven't put weight on it yet and I have an appointment today. I'll see how that goes. I'm just frustrated because all I does was shatter my ankle 10 years ago and now this doctor wanted to perform all these procedures. :confused:

I'm upset because he didn't really explain why and I wish I would've done more research.

ZenVegas 06-12-2009 09:37 AM

Re: Having Brostrom Procedure in a week - what should I expect?
I just did the brostrom procedure. I feel it was unnecessary since my ankle was SLIGHTLY loose. It seems like your second brostrom procedure went well. I'm debating about having my ligaments loosened. I mean I just got the surgery 5 weeks ago, but I don't think it was necessary. I just needed my screws and plate removed from a previous injury.
How are you feeling now? Do you have full range of motion in your ankle? Do you still have pain.

Norrissimo 07-26-2009 04:29 PM

Re: Having Brostrom Procedure in a week - what should I expect?
Hi i am new to this board thing...i hope you can help me with some advise...i fractured my talus 2 years ago had surgery to debris the fractured bone under athroscopy last year 08. Still have pain so had an MRI and have found out that i have only 1 ligament. The AFTL and CFL are gone no wonder it still felt unstable....i am told i need more surgery but not immediately. I can wear a brace but dont feel confident to run which is what i really want to do. Have you had ligament reconstruction? if so which type, how long ago and how long were you off for? how much time did you leave before you had surgery and do you know whether the length of time you leave it for makes a difference when you are older...i am thinking other complications...sorry lots of questions......thanks

ZenVegas 07-27-2009 06:11 PM

Re: Having Brostrom Procedure in a week - what should I expect?
Do not get surgery unless it is absolutely necessary.
I regret having this procedure but I was misdiagnosed.
Try conservative methods. The recovery and pain is not worth it.

Norrissimo 08-02-2009 02:29 PM

Re: Having Brostrom Procedure in a week - what should I expect?
Hi I am really sorry to hear that the surgery didnt go to plan can you explain what you were diagnosed with and what has happened since>? It may help me out?

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