Name of the Procedure:

Repair, dislocating peroneal tendons; without fibular osteotomy Common name(s): Peroneal tendon repair

Summary

In this procedure, surgeons repair peroneal tendons that have become dislocated but without needing to perform a fibular osteotomy, which involves cutting and reshaping the fibula bone.

Purpose

The procedure addresses the issue of dislocating or unstable peroneal tendons. The goal is to stabilize the tendons, alleviate pain, and restore normal function to the ankle, improving mobility and reducing the risk of further injury.

Indications

This procedure is warranted for patients experiencing recurrent ankle pain, swelling, and instability due to dislocating peroneal tendons. It is suitable for patients who do not respond to conservative treatments like physical therapy, bracing, or medication.

Preparation

Patients may be instructed to fast for a certain period before the surgery and might need to adjust current medications, especially blood thinners. Pre-operative assessments such as physical exams and imaging studies (e.g., MRI or ultrasound) are often required to evaluate the condition of the tendons and surrounding structures.

Procedure Description

1. Anesthesia: The patient is given regional or general anesthesia.
2. Incision: A small incision is made near the back of the ankle.
3. Tendon Repair: The surgeon repositions the dislocated tendons and secures them in place, often using sutures or a tendon groove to prevent future dislocation.
4. Closure: The incision is closed with sutures, and a bandage or splint is applied.

Tools and Equipment: Surgical instruments for soft tissue handling, sutures, possibly a tendon groove creation set.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The repair is usually performed in a hospital or an outpatient surgical center.

Personnel

The procedure involves an orthopedic surgeon, surgical nurses, and an anesthesiologist.

Risks and Complications

Common risks include infection, bleeding, and reactions to anesthesia. Rare complications might involve tendon re-dislocation, nerve injury, or prolonged pain and swelling. Proper surgical technique and post-operative care are vital to manage and prevent these complications.

Benefits

Patients can expect reduced pain, improved ankle stability, and enhanced mobility. Benefits are often realized a few weeks after surgery as the tendons heal.

Recovery

Post-procedure care includes rest, ice, compression, and elevation (RICE protocol). Patients are typically advised to avoid weight-bearing activities initially and might need crutches. Physical therapy often follows to regain strength and flexibility. Recovery time varies but can range from 6 weeks to several months. Follow-up appointments are crucial for monitoring healing progress.

Alternatives

Non-surgical options include physical therapy, ankle bracing, and anti-inflammatory medications. For some patients, these alternatives might be less effective in providing long-term relief compared to surgery.

Patient Experience

Patients will likely experience some discomfort and swelling post-surgery, managed with prescribed pain medications. The initial recovery period includes restricted movement, but gradual improvement is expected with adherence to rehabilitation protocols. Comfort measures like elevating the foot and using ice packs can help mitigate post-operative pain.