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Advice on Peroneal Tendon Surgery


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Old 07-13-2018, 01:39 AM   #1
Hugaporcupine
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Advice on Peroneal Tendon Surgery

Hi all! New here, hoping for some advice on whether I should have surgery on my right ankle. I've been in a walking boot for about 2 weeks, but I haven't seen much improvement yet.

First, to explain the problem. I'm a 35 y.o. female. I've had extreme pain behind and under my lateral ankle since February. At first I figured it would get better on its own, but after almost 3 months, it was just getting worse and was swollen the size of a golf ball at the end of every day. I finally saw my doctor and had an MRI done. The MRI showed a split-thickness tear of the peroneus brevis tendon with tenosynovitis, and a Grade 2 sprain in the PTFL (posterior talofibular ligament). I took the MRI results to a podiatrist/surgeon. He explained that the PTFL injury is really very rare, that I have extremely high arches that need custom orthotics, and that I could try conservative treatment or have surgery, depending on how much the injury was bothering me. I decided to go with the walking boot and to think about surgery.

I have concerns about having the surgery. I haven't talked to the doctor in depth about it yet (I see him on Tuesday), but I know it's an option and I know conservative treatment usually doesn't help much with this type of injury. But most of my concern stems from experience with knee surgeries 10 years ago. I am currently in PT (physical therapy) for lower back pain, and have found out that my legs remained very weak after rehab for the knee surgeries, which contributed to major disc degeneration in my lower back. My legs, especially my left leg (which had the more extreme surgery) are still very weak. I'm worried my left leg won't be strong enough to compensate for a right ankle surgery. I'm worried about there being other unforseen problems that arise after the ankle surgery (like my back problems after knee surgery). I'm concerned about the likelihood of re-injuring the ankle due to my high arches and because I sit "Indian-style" all the time, which the doctor said is contributing to the ankle damage. I had to learn to step up & down with my right foot first after my knee surgery, and it wasn't easy. After 10 years I still forget sometimes until it's too late and I get a shooting pain inside my left knee. I don't think I could force myself to sit a different way forever, but I don't know if that would be necessary to prevent more damage after surgery.

At the same time though, I don't think I can put up with the ankle the way it is much longer. It's only either stayed the same or gotten worse. It's so painful I'm in tears a lot of nights. It hurts even while resting after normal daily activity. I'm also worried about continuing to walk on it like this and causing damage that is harder to repair later. I already have difficulty walking, and this ankle is just making everything more difficult and more painful.

So I really don't know what I should do. When it comes down to it, I'm scared that if I don't have the surgery my ankle will only get worse. And I'm scared if I do have the surgery that it won't be a definitive fix and that it could cause problems in other areas. Does anyone have experience with this injury and/or surgery? I'm particularly interested if anyone else has damaged their PTFL in isolation like this and what, if anything, was done to fix it. Also wondering if anyone knows anything about chances of re-injury following this surgery. And any helpful advice or words of wisdom would definitely be appreciated. Thanks in advance everyone!

 
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Old 07-17-2018, 08:27 AM   #2
ballerina26
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Re: Advice on Peroneal Tendon Surgery

Hey! I feel like I was suffering a lot of similar problems to you. I had a torn ATFL and peroneal brevis. I was also concerned about surgery and crutches causing more problems in me since I have hip issues on my uninjured right side. I'm about 3 weeks post op for a peroneal tendon repair and brostrom and things are starting to improve. The tingling has faded and I no longer have to elevate my ankle all day. I'm PWB for 2 more weeks and than I will be able to walk in the boot. At 6 weeks I'm supposed to be full weight bearing and start PT. I also wasted a lot of time and money trying conservative methods and I wish I just went with surgery first since I would be closer to a full recovery by now.

Some of my fears about worsening hip issues did happen though since it's hard to support all your weight on one leg even without any pre-existing conditions. My right hip is constantly popping and my right knee has some pain from constantly rising and standing on one leg and balancing. Once I was PWB it got a lot better and I could at least use my injured side for balance. Overall I just spent a lot of time lying down. Sitting is worse on your back so I just lie down on the sofa or bed most of the day. Because the rest of my body is not so great I haven't been as active as I hoped to be and probably won't be going out to walk several blocks on the crutches.

If you can afford it the iwalk seems cool since you can attach it to your knee and it's like an artificial lower leg that will help you walk. Knee scooters could also help if you need to get around a lot.

Maybe while you are on crutches you could see a chiropractor or PT to help keep your back from getting too out of alignment.

Taking the time to find a good surgeon is important and don't worry about the ankle getting worse. If you are in a boot it won't cause it to get so bad you need a more invasive complicated surgery. With the level of pain you're in it seems like surgery would be the best option but you could talk to doctors who do PRP or stem cell injections for smaller less serious tears. Good luck with everything and hope you are feeling better soon!

 
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