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Tuesday, April 29, 2014

Peroneal Tendon Repair Post Op: Email Advice

Hi Dr Blake,

I am so happy to have found your website and think what you are doing to help others is truly an amazing and generous thing.

I live in Canada and having access to my  surgeon  outside of office or clinic just isn't something we get.

Having said that I turned to Google and came across your site.

I am a 43 year old mom and EMT.   A very busy, active person typically.

On April 7/14 (3 weeks ago) I had a peroneal tendon repair/ transfer .   My first post op visit was a week ago, April 22/14.   My surgeon said the incision looked good and explained what he found and did during the surgery.   My brevis tendon was more then 50% torn so he removed over 50% of the tendon, repaired the rest and attached it to the longus tendon.    Post op instructions were to be on strict bed rest elevating my leg for the first 2 wks....which I complied with religiously.  I expected to be allowed to start walking on it with crutches and that I would be placed in an Aircast at the 2 wk mark.   I was very wrong.   I was placed in a fiberglass cast on April 22 and instructed to not put any weight on my leg for another 3 weeks which takes me toMay 13 when I have my 2nd post op appt.   Disappointing as that was I got over it and have been relatively compliant with the exception of putting my foot on the ground for balance.
Dr Blake's comment: Common post op protocol for this type of procedure is 1-2 weeks compression dressings non weight bearing with splint, then 3 weeks more non weight bearing in fiberglass cast, then 4 weeks in a removable cast with crutches (to advance to full weight bearing), and then 3-6 weeks in an Aircast Brace to gradually return to walking without the boot. I think you were not advised correctly, but you are being treated correctly from this stand point. 

My question is.....24 hrs after the cast went on I experienced an increase in pain and the top of my foot at the base of my toes had a significant increase in bruising that extends the width of my foot and into my big toe. from edge of cast to toes is purple, black and blue and 2 days ago started experiencing an ache in my calf and it feels like the cast is tighter in the calf and top of foot.    I'm still elevating my leg majority of the day and still sleeping with it elevated. Is this normal?
Dr Blake's comment: No, the cast is too tight. Please have removed ASAP and a looser more padded cast reapplied!!!! 

Your thoughts would be greatly appreciated.

Kind regards,




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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.