Guest guest Posted December 2, 2005 Report Share Posted December 2, 2005 Okay - I know I've gotten the basic info but I've got a few more questions. *Are all of the casts non weightbearing or do they put walking casts on them at some point? *What are the scars like after awhile? How many are there? I've seen that there are some on the top and some on the bottom of the foot, right? Any pics would be good for dh to see if you have them. *What is the follow up like? Do you still wear the shoes? Do you follow up annually? Biannually? *How long was your hospital stay? *If you have an older child who had this were you happy with the results? Have they had any pain from the scars, etc? * I've tried to look up info but can't find what I'm looking for so can you tell me do they cut muscle and such or just what is done on the inside of the foot? I think that will do us for now. Thanks for taking the time to help us if you can. Chris A waist is a terrible thing to mind. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 3, 2005 Report Share Posted December 3, 2005 You'll probably get loads of information from the site, but we'll write shortly - Henry had his ATTT about three months ago - great experience!!!! Talk to you soon - Pete and > Okay - I know I've gotten the basic info but I've got a few more > questions. > *Are all of the casts non weightbearing or do they put walking casts > on them at some point? > *What are the scars like after awhile? How many are there? I've seen > that there are some on the top and some on the bottom of the foot, > right? Any pics would be good for dh to see if you have them. > *What is the follow up like? Do you still wear the shoes? Do you > follow up annually? Biannually? > *How long was your hospital stay? > *If you have an older child who had this were you happy with the > results? Have they had any pain from the scars, etc? > * I've tried to look up info but can't find what I'm looking for so > can you tell me do they cut muscle and such or just what is done on > the inside of the foot? > I think that will do us for now. Thanks for taking the time to help > us if you can. > Chris > A waist is a terrible thing to mind. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2005 Report Share Posted December 4, 2005 Kassia, Thank you so much! I am glad your rambled. My husband is feeling more comfortable with the need for this surgery and notes like yours really help. I so appreciate the time you took to share and yes, patient education is obviously a passion. I'm a teacher so I totally understand! Thanks again, Chris Re: More ATTT Questions Hi Chris! Jake has a left clubfoot and relapsed around the age of 2...he has had ATTT surgery twice now and is still recovering from his second surgery (it was on October 18, at the University of Iowa with Dr Dietz). Here's out take on it! Sorry in advance as I tend to give kind of long posts... *Are all of the casts non weightbearing or do they put walking casts on them at some point? The first time Jake had the surgery, he just had one cast that went from toes to mid-thigh, with the knee bent, for 6 wks. It was to be nonweightbearing, but Jake would frequently try and stand on it (he was just over 3 yrs old at the time and didn't really want to listen to us about it lol). Dr Dietz said that one 6 week, nonweightbearing cast is what he usually does following ATTT surgery. The second time Jake had the surgery, he had a nonweightbearing cast (same as the first one) for 6 wks. He was MUCH more aware of the risks of standing/walking on the cast...he does NOT want to have surgery again so he was very very good about crawling instead of trying to stand or walk. Because the tendon pulled out a little last time around (more on that later!), Dr Dietz opted to put Jake in a second walking cast for 3 wks, to help keep his foot in correct alignment and hopefully make sure it is healed well before he goes cast-less. Jake will go back to have his walking cast removed on Dec 16. *What are the scars like after awhile? How many are there? I've seen that there are some on the top and some on the bottom of the foot, right? Any pics would be good for dh to see if you have them. Jake had 3 scars after his first surgery. Two of them were about an inch long apiece on the top of his foot, one towards the inner (where the tendon was to begin with) and the other towards the outer (where the tendon was moved to). He also had a larger incision (maybe 2 inches long or so) on the back of his lower leg because he had another achilles tenotomy. There was also a teeny spot on the bottom of his foot where the suture and button came out, but after a few weeks we couldn't see that one. Second time around, Jake also has a small incision (I didn't get a good look at it during the cast change so I don't know how big it is) on the bottom of his foot because they did a tendon release on his arch (it has become very high over time (they don't know why) and was actually making his clubfoot about a size and a half shorter than his other foot). As far as the long-term appearance of the scars...Jake's faded to just white lines as they healed (they were dark pink to start with), but this really depends on how your child heals. Everyone is different. I will check around on my computer; I'm not sure if I have any pictures of his foot or not. If I can find any I'll send em to you. *What is the follow up like? Do you still wear the shoes? Do you follow up annually? Biannually? After having this surgery done, the shoes are not necessary according to Dr Dietz, because this surgery usually corrects the clubfoot without the possibility of relapse. I'm not sure about long-term follow up. Jake was seen twice in the year following his first ATTT, but his was a special case as the tendon pulled out a little and Dr Dietz was anticipating having to re-do the surgery. *How long was your hospital stay? Overnight. Both times we left the hospital around noon the day after surgery. *If you have an older child who had this were you happy with the results? Have they had any pain from the scars, etc? This is kind of a loaded question for us! Keep in mind that our surgical experience is *not* the norm. For most children, ATTT surgery fixes their clubfoot and they have no long-term issues. For Jake, though, apparently his tendon pulled out slightly from the bone (we're not sure exactly how that happened, if it was Jake attempting to stand on his cast or what) so that it could not lift his foot as it should. He could walk & run just fine but over time was walking on tip toes more and more. In the months before his second surgery he actually could not walk flat-footed. This didn't slow him down in the least, though, and he did not appear to have any pain of any kind. So, for our second surgery, instead of just having a suture to hold the tendon in place, Dr Dietz also put a screw in (it is very tiny, and *dissolves!* I'd never heard of such a thing). He said it's kind of like wearing both a belt & suspenders to hold your pants up...extra insurance. At our cast change appointment, Dr Dietz said he was satisified with the results. Jake was very hesitant to flex his foot up & down (I'm sure his muscles were very sore after being in a cast for 6 wks) but he did move it a little. Dr Dietz also noted that he couldn't feel any lumps on the top of Jake's foot, which he had before the surgery, apparently from the tendon being bunched up from pulling out. We'll have to wait & see until after the walking cast comes off & Jake is back to running & walking as far as whether or not the surgery was successful. * I've tried to look up info but can't find what I'm looking for so can you tell me do they cut muscle and such or just what is done on the inside of the foot? Basically, with this procedure the anterior tibialis tendon is detached from the bone on the inner side of the foot, and is reattached to a bone on the outer side of the foot. Usually an xray is done before surgery to make sure the bone is large enough to do the surgery (if it isn't, they have to wait awhile to do the surgery). A hole is drilled through the bone and the tendon is inserted into the bone. Basically this is how tendons attach to bones, they actually are a part of the bone. Anyhow a suture is used to hold the tendon in place and the stitch actually comes out the bottom of the foot and is tied through a button to hold it in place. The suture is removed after the cast is taken off. The general idea is that the tendon, in its original position, is too tight and pulls the foot inwards. It is moved to the outer side of the foot so that it keeps the foot in correct alignment. * What is a plantar facsia release? Is this what causes the 'button scar' on the bottom of the foot? No, the plantar fascia release is a different procedure...I think it's similar to the achilles tenotomy but on the bottom of the foot instead. Hope this helps and again I'm sorry I rambled on so. One of my loves as a nurse is patient teaching...can you tell? Best of luck to you and your family. Kassia 3/22/01 (Lt clubfoot, 2nd ATTT Oct 2005) and 11/22/02 Quote Link to comment Share on other sites More sharing options...
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