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  • 15 Year Old posterior tibial tendon reconstructive surgery.

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    Old 05-21-2014, 06:22 AM   #1
    shragae
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    15 Year Old posterior tibial tendon reconstructive surgery.

    My 14 (soon to be 15) year old son is scheduled to have posterior tibial tendon flat foot reconstructive surgery this summer. He has severe flexible pes planus (flat feet) in both feet. His ankles are turning "inward" and he is walking on the inside of his feet. His feet, knees, hips and back all hurt pretty much all the time.

    And let me remind you, he is 14.

    He has been to a podiatrist for years, and has had orthotics for years. They haven't really helped and this year his feet just got ten times worse. I took him to a pediatric ortho who did a ton of tests including CT scans. She tried a month of PT which helped very little. . .

    When she mentioned surgery -- calcaneal lengthening she called it -- I decided we needed to see a foot and ankle ortho. I found a board certified one who teaches at the local medical school. He's done about 1000 of these procedures. After looking at my son's feet, X-Rays & CT scan he said his calf tendon is really tight and that he needs to have the tendon replaced (?) along with having his heel broken in two places, a cadaver bone to extend the foot and about 3 other things I forget. He gave me a paper which called it posterior tibial tendon flat foot reconstructive surgery.

    This is supposed to be out patient surgery -- 4 hours -- on one foot. We're starting with the right foot. He'll see a PT to learn how to maneuver on crutches or some other mobility device prior to the surgery. Post op recover is 3-4 months. Oh, DS's feet are a men's size 13 and still growing! The doctor said that the fact that he is still growing will help his recovery. . .

    I do feel comfortable with this doctor -- he really knew his stuff (I could tell he was more knowledgeable than the pediatric ortho). My son is scared and now wants a 3rd opinion - -but there really is no point. There is no doubt this has to be done. . .

    BTW, I am a single mom who works. Since the plan is for this to be out patient -- what should I do to ensure my son has the support that he needs post-surgery? What will insurance cover (if anyone has a guess)?

     
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    Old 05-21-2014, 07:37 AM   #2
    Newm
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    Re: 15 Year Old posterior tibial tendon reconstructive surgery.

    Shragae, It is really difficult for 14 years boy, but I think your son should know when he has rigid foot, he will not run anymore and surgery will be also inevitable.
    I am also suffering from PTTD.

     
    Old 05-21-2014, 07:45 AM   #3
    shragae
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    Re: 15 Year Old posterior tibial tendon reconstructive surgery.

    Ortho says he has flexible flat feet, not rigid.

     
    Old 05-21-2014, 07:58 AM   #4
    debdeb24
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    Re: 15 Year Old posterior tibial tendon reconstructive surgery.

    It is a tough surgery. I had a lot do to my foot. I've had bad feet since I was a kid. I wish I would have gotten my done yes ago. I think healing will be a lot faster for a 15 year old.
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    Old 05-21-2014, 04:32 PM   #5
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    Re: 15 Year Old posterior tibial tendon reconstructive surgery.

    Bless his heart for needing to have this done at such a young age, but actually in many ways the fact that he is so young will be in his favor. From what you described it sounds like he'll have what is called a Gastroc Recession (this is where they lengthen the tight calf muscle), and a Calcineal Osteotomy (where they cut the heel bone to realign the foot---the foot gets out of alignment because of the arch collapsing). As far as the tendon goes, it sounds like they will remove the bad part of the tendon and then reconnect it to another tendon to lift the arch again. It's a very rigorous recovery because of the long non-weight bearing period. Since he's young he'll likely do better with crutches than us "older" folks, but if your insurance will cover it, I would also recommend looking into a knee scooter, especially since his other foot isn't that great. The knee of his operative foot will rest on a knee pad and can help with some of the weight, so that he's not putting all his weight on that other bad foot. Just Google knee scooter and you can see pictures and learn how it works. They're really pretty neat. I loved mine. It made getting around so much easier than crutches---although crutches are better in tight spaces. As far as help post-op, it would be good if he could have someone with him 24/7 for the first few days, especially if he's on heavy pain meds. He'll likely feel pretty out of it and probably won't want to do much more than lay in bed or recline on the couch and elevate his leg and foot, maybe watch some TV. The splint they put on following surgery is pretty cumbersome and will take a little time to get used to. After those first few days make sure he has plenty to keep his mind occupied. That is the biggest challenge, because you start feeling better physically but you can't do much but just sit and elevate. The more he has it elevated the less likely he'll be in pain. If he's up & about a lot with it hanging down it will swell quickly and get painful. So make sure you have plenty of things for him to do while sitting. I hope this info helps, and best of luck to you as the caretaker & mother and him as the patient. Make sure you read the article on coping while non-bearing. Full of tons of helpful info.
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    1/16/14-FDL tendon transfer, calcaneal osteotomy, Gastroc Recession
    6/4/15-Naviculocuneiform arthrodesis, removal of scar tissue, Evans osteotomy, Achilles lengthening

     
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    calcaneal osteotomy, flat flexable feet, tibialis posterior



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