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Repair of Tear of Posterior Tibial Tendon

Surgery
Simple repair of the posterior tibial tendon is done when the tear is small, and has not been present for a long time. This is done as an outpatient procedure, and requires a general anesthetic. The lining over the tendon is opened, exposing the tendon and the tear in its substance. I will cut out the torn segment, and sew together the healthy tendon tissue.

               Posterior Tibial Tendon Incision.jpg

There will be a curving scar that runs along the inside of the ankle and hindfoot for about 4 inches.

Day of Surgery
At the end of the surgical procedure the wound is covered and a short leg plaster splint is applied with the toes pointing downward and inward (plantarflexed and inverted). That dressing gives support to your ankle, holding it securely. You should leave that in place until I change it at the first post-operative office visit.

You will be given crutches at the surgery center, and I want you to not put any weight on that leg during the first week. If the splint gets wet or there is a problem with it, please call the office so I can remove it myself.  Do not walk on the splint.

Look here for things to watch for after outpatient surgery.

Post-operative Course
Dealing with post-operative pain will be your major concern for the first few days.

Most people find that for the first few days after surgery their foot will feel better if it is elevated. Generally, if you let it hang down for any period of time it will throb and you may have more swelling. You can put it into whatever position feels best, but usually that will be elevated with a pillow under the foot.

The first post-operative visit is usually 7 – 10 days after surgery. I will remove the splint and dressings, wash your leg, and take out the skin stitches.

After the skin stitches have been removed you can shower or bathe your foot, then towel it dry and put a clean sock over it. I will give you a prescription for a CAM Walker at that visit.  You will use that for protected weightbearing until 6 weeks after surgery. If your surgery was on the right side you should not drive until you can wear a regular shoe. You should not sit in a hot tub until 2 weeks after surgery.

The second post-operative visit is usually at the 6 week point. At that time I will check to make sure that everything is healing satisfactorily. I will then allow you to wear whatever shoe feels comfortable. I will ask to see you one more time after an additional 4 – 6 weeks. If there are any problems or questions then we will deal with them as they present.

Most patients have swelling about the surgical area that lasts for about 4 months after surgery. You should not resume athletic activities for between 3 – 4 months after surgery.

Final Results
The goal of the surgery is to leave you with a painless foot and leg that will allow normal activities. You should be able to regain full strength and power in the leg and ankle, and have no restriction of motion. Some patients will have some mild soreness still. Some will notice discomfort when the weather changes.

Complications
Complications can occur with any surgery.  Go here for a general discussion of Surgical Complications.

Specific risks of this procedure include persistence of pain, and the need for further treatment with a brace or another operation.




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