So the leg cast is off
Hi folks,
Surgery was done on May 5th, and they took the lower leg cast off this morning, How I'll get through this again but longer if they do the tendon transfer I don't know. 4 weeks nearly sent me demented.
The surgery was planned to be calf lengethen, rec-fem lengthen and tib ant split tendon transfer. But once they started they found that the calf was too tight and while they lengthened as much as they could in the calf, if they do the tendon tranafer on a too tight calf it either won't heal (would tear off under pressure) or it will stretch and be useless in 6 months time. So they did the rec-fem (quad) and the calf and I lived in the lower leg cast for 4 weeks so that the calf had to heal in the extended position.
So the rec fem healed very quickly and nicely, and I once again have full range knee flexion. Still have to keep at my stretches to make sure it stays at this length as the tendon regrows. The really nice thing about this bit is that its taken the pressure off my hamstring and pelvis, so I can use my hamstrings much more easily as they've been fighting the too short fec rem so have always been partially on, and as my pelvis now sits were it should be and my hamstring isn't fighting my knee seems to have stopped hyper extending as well ( I hope I'm not imagining that we'll see for sure as I start to use the lower leg again.
Now with the cast off I'm back on the crutch as the calf is very weak. we have got at least 5 degrees dorsi flexion now too, needed pressure to get to 0 before surgery. But at the moment when I put any load on it at more than 0 it really hurts, that calf muscle has a lot more healing to do before I can start to load it up properly. I can now lift my toes easily when seated, although I'm now going to have to work on controlling direction of foot placement.
The surgeon is still talking about an AFO as when I was first started to move around his office I was walking very flat footed although not quite at foot drop level. Since then I'm being very careful when walking with the crutch to make sure I lift the toes and get the heel strike to happen. It tires very quickly though so I'm only get about 10 steps with heel strike before the toes don't want to lift, and I have to stop and reset. But I am getting heel strike so hopefully It's just a matter of training and I'll be able to stay without an AFO.
I see him again in 3 weeks for next assesment, and it'll be a 6 month wait with lots of training to see if I can loosen the calf enough for him to try the split tendon transfer, although right now the thought of 7-8 weeks in a cast is much harder now I know what this has been like.
So all up I think it was worth it, although now thw hard work starts again to get the most from it.
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