Re: Surgery for shortened Achilles Tendon

[Guest guest]

I would be nervous about lengthening (therefore, weakening) a tendon where the ligaments are already loose. I'm not saying not to trust your Dr, I'm just not sure I understand the surgery. I wish I had Helen Milligan's email addy (Liz??), she is a PT and a mom to a child with DS, and gave a speech at the CHOP T-21 symposium years back on gait issues in DS. I'm sure she'd have an informed opinion. I'll try to find her email. I do hope you find a way to help him. It sounds very uncomfortable!Sent from my iPhone

Elie, who is 26, has a very wide gait with what I call BEAR WALKING. He does not pronate extremely. But, he is adverse to walking any distance and practices stop, flop and drop (SFD) - altho recently much less as he simply stops and sits at the first available spot.

Over the years he has been in short AFO's for 3 years, and in articulated MAFO's for another 2 years. OF course nothing changed even with concomitant PT. Now, I took him to a podiatrist (we have been the orthopod route only to be told to leave him be - after all he is 'retarded'). This podiatrist is very experienced in sports medicine, foot and ankle. HE says that there is a 'simple surgery' to lengthen the Achilles tendon. However, it would require 30 days of either crutch walking (not going to happen!) or wheelchair. He said doing one foot, waiting 5-6 months and doing PT would give Elie the best chance of improving his gait - even though he doesn't realize (cognitively his gait is hampering him . He could also do both feet at once and thus get him into PT faster, but that would be more difficult for the 30 days.

OPINIONS are being solicited. Anyone have this done? -- Sara- different pathways lead to Nirvana.

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[Guest guest]

Sara,

I know I'm not much help but we are contemplating the same thing with . The one podiatrist recommended botox treatments, but that would require casting for 4 weeks after each procedure and it would have to be done 3-4 times. There's no way that can keep a cast on that long especially because of the problem we would have with urine leaking ito it every day. The second option is the surgery to lengthen the tendon but like Elie, there's no way crutches will work,. Not sure how I'd keep him in a wheelchair either. I wanted to get this done before hot weather but I keep procrastinating. They didn't tell us 30 days though. He said after the surgery the cast would be more to protect him from hurting the site and that he could probably stand on it in a week.

I will be reading to see what opinions you get.

Terry

Surgery for shortened Achilles Tendon

Elie, who is 26, has a very wide gait with what I call BEAR WALKING. He does not pronate extremely. But, he is adverse to walking any distance and practices stop, flop and drop (SFD) - altho recently much less as he simply stops and sits at the first available spot.

Over the years he has been in short AFO's for 3 years, and in articulated MAFO's for another 2 years. OF course nothing changed even with concomitant PT.

Now, I took him to a podiatrist (we have been the orthopod route only to be told to leave him be - after all he is 'retarded'). This podiatrist is very experienced in sports medicine, foot and ankle. HE says that there is a 'simple surgery' to lengthen the Achilles tendon. However, it would require 30 days of either crutch walking (not going to happen!) or wheelchair. He said doing one foot, waiting 5-6 months and doing PT would give Elie the best chance of improving his gait - even though he doesn't realize (cognitively his gait is hampering him . He could also do both feet at once and thus get him into PT faster, but that would be more difficult for the 30 days.

OPINIONS are being solicited. Anyone have this done?

--

Sara- different pathways lead to Nirvana.

[Guest guest]

the cast will be for 30 days - 4 weeks and will be up about mid calf.  It is to position the foot with the foot bent  slightly UP (can't remember the medical term - old brain) the opposite of ballet pointe.  The surgery makes three to four slits in the tendon (2 stitch incisions) to lengthen the short and TIGHT (not lax or relaxed)   tendon.  And this for each foot.  If one foot is done, then he will be able to stand to pivot.  but that means 2 surgeries.   Otherwise, we will have to have someone who can lift him - at least for the first couple of weeks.  II am waiting to discuss this all with as well - since he does the day to day care taking.  

Still soliciting parent input.  

 

Sara,

 I know I'm not much help but we are contemplating the same thing with . The one podiatrist recommended botox treatments, but that would require casting for 4 weeks after each procedure  and it would have to be done 3-4 times. There's no way that can keep a cast on that long especially because of the problem we would have with urine leaking ito it every day.  The second option is the surgery to lengthen the tendon but like Elie, there's no way crutches will work,. Not sure how I'd keep him in a wheelchair either. I wanted to get this done before hot weather but I keep procrastinating.  They didn't tell us 30 days though. He said after the surgery the cast would be more to protect him from hurting the site and that he could probably stand on it in a week.

I will be reading to see what opinions you get.

Terry

Surgery for shortened Achilles Tendon

 

Elie, who is 26, has a very wide gait with what I call BEAR WALKING.  He does not pronate extremely.  But, he is adverse to walking any distance and practices stop, flop and drop (SFD) - altho recently much less as he simply stops and sits at the first available spot.

Over the years he has been in short AFO's for 3 years, and in articulated MAFO's for another 2 years.  OF course nothing changed even with concomitant PT. 

Now, I took him to a podiatrist (we have been the orthopod route only to be told to leave him be - after all he is 'retarded').  This podiatrist is very experienced in sports medicine, foot and ankle.  HE says that there is a 'simple surgery' to lengthen the Achilles tendon.  However, it would require 30 days of either crutch walking (not going to happen!) or wheelchair.  He said doing one foot, waiting 5-6 months and doing PT would give Elie the best chance of improving his gait - even though he doesn't realize (cognitively his gait is hampering him  .  He could also do both feet at once and thus get him into PT faster, but that would be more difficult for the 30 days.

OPINIONS are being solicited.  Anyone have this done?  

--

Sara- different pathways lead to Nirvana.

-- Sara- different pathways lead to Nirvana.

[Guest guest]

I am also concerned about mrsa if we do the surgery. Seems like so many people who have had surgery lately get infected with it. If it's casted how do they check the incisions?

Surgery for shortened Achilles Tendon

Elie, who is 26, has a very wide gait with what I call BEAR WALKING. He does not pronate extremely. But, he is adverse to walking any distance and practices stop, flop and drop (SFD) - altho recently much less as he simply stops and sits at the first available spot.

Over the years he has been in short AFO's for 3 years, and in articulated MAFO's for another 2 years. OF course nothing changed even with concomitant PT.

Now, I took him to a podiatrist (we have been the orthopod route only to be told to leave him be - after all he is 'retarded'). This podiatrist is very experienced in sports medicine, foot and ankle. HE says that there is a 'simple surgery' to lengthen the Achilles tendon. However, it would require 30 days of either crutch walking (not going to happen!) or wheelchair. He said doing one foot, waiting 5-6 months and doing PT would give Elie the best chance of improving his gait - even though he doesn't realize (cognitively his gait is hampering him . He could also do both feet at once and thus get him into PT faster, but that would be more difficult for the 30 days.

OPINIONS are being solicited. Anyone have this done?

--

Sara- different pathways lead to Nirvana.

--

Sara- different pathways lead to Nirvana.

[Guest guest]

The incisions are micro - 2 stitches.  When I had susrgery after my shattered arm with THREE long incisions and a cast, they checked the incisions each cast change - which was after 3 weeks the first time.  My guess is sthat the tiny incisions will heel - if there is no MRSA>  But we have had good luck so far with the OP at our local hospital - several OP surgeries with no issues for we parents.

I am more concerned with managing him AFTER surgery.  NO walking?  casts on one or both feet.  Doc says NO bathing.  Only sponging for the 30 days.  And biggie - using a w/c which he loves - will I be able to wean him OFF the thing after surgery??  And then of course - will it really help????

 

I am also concerned about mrsa if we do the surgery. Seems like so many people who have had surgery lately get infected with it. If it's casted how do they check the incisions?

Surgery for shortened Achilles Tendon

 

Elie, who is 26, has a very wide gait with what I call BEAR WALKING.  He does not pronate extremely.  But, he is adverse to walking any distance and practices stop, flop and drop (SFD) - altho recently much less as he simply stops and sits at the first available spot.

Over the years he has been in short AFO's for 3 years, and in articulated MAFO's for another 2 years.  OF course nothing changed even with concomitant PT. 

Now, I took him to a podiatrist (we have been the orthopod route only to be told to leave him be - after all he is 'retarded').  This podiatrist is very experienced in sports medicine, foot and ankle.  HE says that there is a 'simple surgery' to lengthen the Achilles tendon.  However, it would require 30 days of either crutch walking (not going to happen!) or wheelchair.  He said doing one foot, waiting 5-6 months and doing PT would give Elie the best chance of improving his gait - even though he doesn't realize (cognitively his gait is hampering him  .  He could also do both feet at once and thus get him into PT faster, but that would be more difficult for the 30 days.

OPINIONS are being solicited.  Anyone have this done?  

--

Sara- different pathways lead to Nirvana.

--

Sara- different pathways lead to Nirvana.

-- Sara- different pathways lead to Nirvana.