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  • Brostrom Procedure... prep, recovery, tips?

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    Old 02-19-2013, 01:44 PM   #1
    ankle problems
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    Question Brostrom Procedure... prep, recovery, tips?

    Hi all,

    I have scheduled a Brostrom procedure for my right ankle in 3 weeks. I have had a ligament reconstruction on my left ankle 6 years ago, I can't remember much of the surgery- I just know its a long and painful recovery, and I was in pain meds induced haze for the first week.
    I have since had a history of sprains on my right ankle as well- apparently I have hyperlaxity (over elastic ligaments). After 3 pretty severe sprains in one year that left me struggling to walk, I decided enough is enough. The doctor mentioned that the MRi shows anterior talofibular and calcaneofibular ligaments are damaged but not torn, so he is doing a Brostrom repair.

    I am pretty anxious about the Brostrom- my last surgery was in India and completely different healthcare system-the doctor got me crutches, his office sent someone to change casts to my house, etc. This time around I am in NY, and I have a ton of questions:- where do you get crutches? Does the doctor usually provide it? How bad is the pain in first few days? Is it easy to walk around on walking boot? How long was the recovery time? Is the ankle unstable even after the repair?

    Any help would be greatly appreciated!!

     
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    Old 02-19-2013, 06:44 PM   #2
    Erie0385
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    Re: Brostrom Procedure....prep, recovery, tips?

    Welcome to the boards!
    I feel like a veteran of the Brostroms. I had my first modified Brostrom 10 years ago. They tightened the ATFL and I had wonderful success with that. Then 10 months ago I badly sprained my ankle again. (I have super loose ligaments as well.) After the dr got in there I pretty much shredded my AFTL and CFL. This time he did a Brostrom-Evans, which splits the brevis tendon in half and rerouts it through the fibula to take the place of the ATFL and CFL. I'm now 10 weeks out, and I'm doing well.

    I will try to answer your questions
    where do you get crutches? Does the doctor usually provide it? This depends. Did the dr office tell you anything about this? If they don't provide them you can either rent or buy them. You can go to any medical supply place for this. Also most drug stores, such as Walgreens will let you rent or buy.

    -How bad is the pain in first few days? I'd say the first 3-4 days the pain was pretty intense. A lot of people opt for a nerve block, and depending, they can last 12-48 hours. This offers a lot of extra relief. I unfortunately didn't luck out, and mine didn't work (rare). Definitely keep up with taking pain pills and don't skip a dose the first few days. Also ice and elevate! Toes above nose. If your in a surgical split or cast still ice. It's not as good, but it does work. Also icing behind your knee really works!

    -Is it easy to walk around on walking boot? Did the dr tell you how long you would be non weight bearing? I was NWB for 6 weeks in a cast. After that I got my boot and WB as tolerated. It's not easy at first. But the more you work at it, the easier it gets.

    -How long was the recovery time? I honestly cannot remember the time frame from my first Brostrom. I feel like it was similar to this last one. 2 weeks surgical splint NWB, 4 weeks NWB cast, 3 weeks WB as tolerated in a boot, and now I just got clerance for FWB in an ASO brace. My walking is still more like limping but it gets better every day.

    -Is the ankle unstable even after the repair? I am only 10 weeks out, but my ankle is so tight right now. I've had a couple close calls on falling over, and my ankle never once tried to roll over. I can already tell I am happy I went through this a second time.

    Did the dr say if he was just fixing the two ligaments? Did he mention another plan if there wasn't much left to fix? My MRI showed mine were just stretched, but he had a feeling there was more to it. So we went with the plan of, if they were okay to sew tighter he'd do that, if not, he'd do the procedure I had done. Since this is the second time your going through with this, I'd be a little surprised that he'd think all you needed was a modified Brostrom. Though I'm not a doctor, just what I have learned through all mine.

    I hope this helps! Ask as many questions as you can before surgery. There are several on here like myself who have had this done, so you've come to the right place
    __________________
    10/2001 Left kneecap tightened and LR
    06/2003 Modified Brostrom on right ankle
    10/2012 Biopsies under general
    12/2012 Arthroscopy, impingement removed with Brostrom-Evans procedure

     
    Old 02-19-2013, 06:53 PM   #3
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    Re: Brostrom Procedure....prep, recovery, tips?

    Hello!
    Erie has answered all of your questions.
    All I can let you know is that I had modified brostrom-gould on 6th Oct 2012 and a few other things as well.
    My surgeon had me in the splint for the first 10 days - toes above nose for 23+hrs per day during this time - was worth it!
    I then went into a cast for 2 weeks. Then into ASO brace and runners up to week 12 - WBAT straight away and managed to go from 2 crutches to 1 in 2 days and then totally off crutches after 6 days (painful, slow walking).
    I am 4.5mths post op now and only wear the brace on the treadmill etc at gym (have been on the treadmill since about week 15 or 16) or if I intend to go on long walks on uneven ground and some physio exercises to help with proprioception. I have been told I won't have to wear the brace at all after 6mths - but I guess I will have to wait until then and see what the physio says.
    But going really well
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    6 Oct '12: OCD talar, lat menis lesion, decomp ant ankle, osteotomy post proc talus, synovec post ankle, modified Brostrom-Gould, release PTT

     
    Old 02-19-2013, 07:39 PM   #4
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    Re: Brostrom Procedure....prep, recovery, tips?

    Thanks Angelee and Erie, your replies are very helpful!

    Erie to answer your question- the doctor had talked about a reconstruction using hamstring tendon for ligament reconstruction. But the MRI showed stretched ligaments, not torn. I was actually surprised- after the sprain in November, it hurt so much to walk that I thought it was torn.
    The doctor said seeing that it is stretched ligaments, it is most likely going to be Brostrom procedure. He said he might prepare for reconstruction but not likely. I am actually worried about the prospect of still twisting it after Brostrom.
    The doctor has indicated 2 weeks of splint, followed by 4 weeks of ankle boot.

     
    Old 03-14-2013, 05:55 AM   #5
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    Re: Brostrom Procedure....prep, recovery, tips?

    HI angelee adn Erie,

    Surgery is done! The doctor has planned a Brostrom repair, but on seeing how stretched out my ligament was, he did the tendon reconstruction instead. He used the tendon from hamstring. I am actually happy, I was worried if the repair would hold.

    When you had the surgery, was your cast heavy too? Right now, the block is still on but the cast feels super heavy. Even as I walk around in crutches, my knees are killing me!

    Thanks again for your tips!

     
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    Old 03-14-2013, 06:28 AM   #6
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    Re: Brostrom Procedure....prep, recovery, tips?

    Glad to hear your surgery is done and it sounds like it went well!!
    Yes - is the short answer to your question.

    The first cast/splint I had was made from POP (plaster of paris) - the heavy stuff!! Sure gives your leg a workout carrying it around!
    Was very glad when I got my fibreglass cast on the 10th day - much, much lighter - almost felt like I didn't have a cast on (other than I couldn't move my ankle - lol).
    Hope your recovery is going well so far.
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    6 Oct '12: OCD talar, lat menis lesion, decomp ant ankle, osteotomy post proc talus, synovec post ankle, modified Brostrom-Gould, release PTT

     
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    Old 03-14-2013, 06:29 AM   #7
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    Re: Brostrom Procedure....prep, recovery, tips?

    I first had a splint for 2 weeks then a cast. And yes, that splint felt like it weighed a ton. You sort of get used to the weight, but your supposed to be mostly down and elevating for about 2 weeks anyways!

    Since this was my second repair the dr split my brevis tendon to reroute in my ankle, and so far I've been happy with the repair. My ankle feels nice and tight, no wobbling at all!

    Good luck with your recovery. Anymore questions, ask away!

    Erin
    __________________
    10/2001 Left kneecap tightened and LR
    06/2003 Modified Brostrom on right ankle
    10/2012 Biopsies under general
    12/2012 Arthroscopy, impingement removed with Brostrom-Evans procedure

     
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    ankle problems (03-27-2013)
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