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several torn tendons in ankle

(2 discussions)

In May, I turned my ankle on a small step in a motel room.
I was in Europe, have had a history of sprained ankles (played BB in HS), and walked on it for 26 days before seeing a doctor about it.
The following is the MRI report:Multiplanar/multisequenced MR imaging of the left ankle performed without gadolinium contrast per standard protocol.FINDINGS: Partial tear/tenosynovitis complex of the peroneal tendon group.
Partial tear signal involves the peroneus longus from a level of the distal fibula distally to the arch of the foot.
This is most pronounced interposing the distal margin of the fibula and the peroneal tuberale of the calcaneus.
Moderate thickening of the tendon with frayed margins as well as a few focal sites of abnormal edematous internal signal.
Despite the abnormality, no retraction of the tendon.Distal to the tubercle, although difficult to visualize, tendon is felt to possess internal tendinitis signal without evidence of high grade rupture.
The peroineus brevis is somewhat more difficult to visualize a few centimeters proximal to the insertion.
The remainder of the course of the tendon felt to be intact with low grade partial tear/tendinitis signal as well.No significant hematoma within the more proximal peroneal musculature.
The lateral ligaments of the ankle remain dark signal.
Mild edematous change involved the anterior talofibular ligament.
The anterior/posterior tibiofibular ligaments segmentally visualized and unremarkable.
Tiny focus of fluid within the retrocalcaneal bursa.
No significant pre-Archilles fat edema.
The Archilles tendon the plantar aponeurosis unremarkable.At the medial aspect of the ankle, very mild tendosynovitis of the posterior tibialis. The flexor digitorum and the flexor hallucis intact.No evidence of fracture nor contusion.
Visualized musculature unremarkable.
A small amount of fluid at the tibiofibular joint.
Unremarkable fatt/ligamentous signal of the sinus tarsus.
I have been in a castboot for 1 month. I returned to see him.
He said to wear it another month.
He said at that time, we might consider surgery. He thinks probably less than a 50% chance it will heal without surgery.
He thinks the surgery is highly likely.
I teach in a little over a month, I would prefer to have as much of the recovery time over as possible. I have a bunion on that same foot that bothers me.
The foot surgeon would do bunion at the same time.
Should I be conservative, or should I just do what is probably inevitable?Any surgery recovery information would be helpful as well, considering the bunion and ankle.
How long in a cast, walking or non, crutches, etc… Thanks!
I have been considering things, see another surgeon on July 14th, but can’t seem to arrive at a decision!!!Many thanks!
Deb


2 comments

    Vivian Abrams DPM

    9 10

    This is just my opinion. I am very conservative and will always try a conservative approach before surgery. Every doctor you see will have a different perspective. I think you are asking alot, if you want to have all this work done and expect to be well enough to be on your feet all the time when school begins. You did not say when you start up again. You probably should discuss this with your doctor and even get a second opinion. Be very specific with your questions and concerns.Repairing the peroneal tendons may be indicated if you are not mending well.

    Avatar

    9 10

    Thanks for the response. I realize hoping to be ready for school is probably not going to happen. I have been wearing the castboot for 5 weeks and the ankle is not much better, if at all. The swelling is actually worse. With tendons all around the ankle partially torn or frayed, there is more than one area that hurts. I have a bunion on the same foot which has bothered me for a long time. I have also had gout in that same joint. The bunion pain never goes away. I have a “Morton’s Toe” is it, that the 2nd toe is longer than the big toe on that same foot as well. It aches sometimes and causes me to have to wear one size bigger shoes, this makes my good foot rub on the oversize shoe. Therefore, the ankle, and foot have several problems. I understand not having things done to both feet at the same time, but doesn’t it make sense, if I have the ankle surgery, that I would get the bunion and the toe fixed at the same time. I will be laid up anyway, and would not want to have to be put out for future surgeries on the toe and bunion. Why be in pain for something they could fix then.Does this make sense, or am I just having wishful thinking? I know either way it won’t be fun. But this isn’t fun either. I have limped for a long time. Thanks again for listening and for your opinion. And, I do have a second opinion with a DPM this week to see what he thinks as well. Deb

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