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    Achilles TENDON Lengthening surg

    For just under a year been getting Botox injections in calf to the stretch achilles tendon to improve(right foot) Dorsiflexion-I have foot drop. This was unsuccessful, and after further Gait analysis I still land on ball of foot wit toe drag. I use hip flexor to clear right foot. My SCI doc is recommending Tendon Lengthening surgery. He indicated it has a high success rate. Will be cast for 6 weeks but can weight bear.

    Has anyone had this surgery with success, please share.

    Shoes: Left 1/2" lift, Right AFO w/ toe slide

    Thanks for all feedback
    Appreciate the small gains and the large ones will be ignored!!

    #2
    Hi Warren, very interesting..

    How did the Dr realize your Achilles was shortened? For how long did it go on?

    thanks very much for answering my questions. I also wear an AFO in one foot. I am sick of it and I am trying to find a way of strenghtening the flickers of dorsiflexion I have on that foot to be able to SOMEDAY maybe get rid of the AFO.

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      #3
      It has been a problem for more than a year. I have no roll at the ankle on right side. For example, when sitting in a chair trying to place both feet flat on floor the heel of my right is raised.
      As far as strenghten that was the goal of botox to weaken the muscle near achilles to then began strengthening the other muscles near shin that lifts foot. This was not successful.

      Sorry for late response had PC troubles
      Appreciate the small gains and the large ones will be ignored!!

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        #4
        I never had surgery but had a similar problem back in the late 80s a year or so after my injury. Severe toe-drop because I was fitted in a quickie folding chair that just had terrible footrests. Rather than a 90 degree turn at the knee, was was more like 115 so my legs stuck waaaay out and toes pointed forward.

        Anyways, the solution for me was a series of foot casts. Basically, the orthopedic guy and the physical therapist would spend about 20 minutes stretching my tendon, getting it as loose as they could. Then they would stretch the ankle up has hard as they dared, and then wrap it in a cast - holding the foot in place as it hardened. About a week or two later, cast would come off, repeat the stretching process and put a new cast on. We did this four or five times, each iteration giving a bit more range on that tendon. Eventually it was stretched to 90 degrees. After that, I got fitted for a set of AFOs that I wear during the day, and haven't had an issue since.

        Not sure if this technique was unusual, or if surgery is considered more effective or efficient in modern medicine. I prefer to avoid surgery if at all possible, as it has so many inherent risks. The medical system makes a lot of money off procedures that are not always in the best interest of the patient, so my advice is just be sure that you've exhausted all your options before going under the knife. Maybe the cast process is considered 'old school,' but it doesn't have a lot of risk and is fairly cheap, I would think.

        Good luck either way!
        -taziar

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          #5
          Have had archiles tendon releases done twice, it's only about a half hour procedure no big deal. I think the first one was done when I was 3 or 4 and the second one done around 17 or 18. Incisions are no bigger then the circumference of a ball point pen, granted I have very small feet.

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            #6
            Originally posted by WarrenJ View Post
            It has been a problem for more than a year. I have no roll at the ankle on right side. For example, when sitting in a chair trying to place both feet flat on floor the heel of my right is raised.
            As far as strenghten that was the goal of botox to weaken the muscle near achilles to then began strengthening the other muscles near shin that lifts foot. This was not successful.

            Sorry for late response had PC troubles
            Do you feel pain in your feet? If so, you will experience some discomfort. If not, it's good for you regarding pain, but you have to be careful not to injure yourself due to lack of feeling.

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              #7
              My husband was going to have this done but when they numbed the foot up for surgery they still could not get everything to stay where it should so they ended up having to put rods, screws, pins, etc. in place to fuse it into correct position.

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                #8
                Thanks Warren. Taziar, the casting and streching thing sound so much more reasonable and less invasive than surgery !

                Comment


                  #9
                  I think that is serial casting that was discussed but do to my lack of sensation. their major concern was skin break down and me not feel it during the castin period. Also, during the surgery they re=assign tendon so you can achieve better Dorsi=flexion

                  La type I wish I felt pain in the feet, light touch is coming back still can't feel pain yet

                  Thanks for all input

                  PS I do aqua therapy obvious that will be shutdown for 6 weeks during the healing period
                  Appreciate the small gains and the large ones will be ignored!!

                  Comment


                    #10
                    Originally posted by WarrenJ View Post
                    I think that is serial casting that was discussed but do to my lack of sensation. their major concern was skin break down and me not feel it during the castin period. Also, during the surgery they re=assign tendon so you can achieve better Dorsi=flexion

                    La type I wish I felt pain in the feet, light touch is coming back still can't feel pain yet

                    Thanks for all input

                    PS I do aqua therapy obvious that will be shutdown for 6 weeks during the healing period
                    I was born with club feet, so I had those surgeries prior to my injury. The absolute worst is when they take off a cast and you go to move the limb. That's a bitch! Luckily, you won't feel it, but I hope the medical professionals around you will be aware of your inability to feel so they know what to tell you not to do.

                    Comment


                      #11
                      Originally posted by WarrenJ View Post
                      I think that is serial casting that was discussed but do to my lack of sensation. their major concern was skin break down and me not feel it during the castin period. Also, during the surgery they re=assign tendon so you can achieve better Dorsi=flexion
                      I have no sensation in my feet as well. Skin breakdown was never brought up as potential issue, at least that I recall, but fortunately I had no complications. Could be that the surgical option simply did not exist back then, so the serial casting was the only way to go. I like to think that treatment has progressed at least a bit in the last 25 years! Reassigning tendons...that definitely sounds like progress...

                      Comment


                        #12
                        http://www.pennmedicine.org/orthopae...eformities.pdf

                        FYI the SPLATT procedure is what was recommended.
                        Appreciate the small gains and the large ones will be ignored!!

                        Comment


                          #13
                          I have the same problem where the left leg is spastic and whenever I stand up, the foot is plantar flexed so i end up in tip toe position. Meds does not seem to help where I take muscle relaxants (clonazepam, sirdalud and baclofen) I was suggested to have heel cord lengthening but have stay put with using the AFO for the meantime.
                          He ai'nt heavy, he is my brother!
                          Rufus Wainright

                          ronaldlora.blogspot.com

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