Repair of Tear of Anterior Tibial Tendon
Surgery
Surgical treatment of an anterior tibial tendon tear is done as an outpatient procedure under a general anesthetic. The repair is done through an incision that runs for about 5 – 6 inches along the front of the ankle and top of the foot medially. The ends of the tendon are brought together and sewn. Sometimes I will put a small metal “suture anchor” into the bone on the top of the foot to hold the tendon back in place. You will not be aware of its presence there. It will be left in the foot for the rest of your life.
Day of Surgery
At the end of the surgical procedure the wound is covered and a short leg plaster splint is applied with ankle extended upward. 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 6 weeks. 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.
I will put you into a short leg cast. This is not a walking cast, so you will still need to use the crutches or walker. You will wear this until 6 weeks after the surgery. Do not walk on the cast.
The second post-operative visit is at the 6 week point after surgery. I will remove the cast, and check to make sure that everything is healing satisfactorily. You will then go into a CAM Walker, and you will wear that for protected weightbearing for an additional 6 weeks. You must wear it when you do any walking.
I will ask to see you one more time after an additional 6 - 8 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 about 6 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 for this surgery include failure of the repair, the need to wear a brace for support, and persistent pain.