27676 Repair, dislocating peroneal tendons; with fibular osteotomy

Name of the Procedure:

Repair, dislocating peroneal tendons; with fibular osteotomy

Summary

This surgical procedure involves fixing the dislocating peroneal tendons by making a cut in the fibula bone to create better stability for the tendons. The tendons run along the outside of the ankle and can become dislocated due to injury or chronic instability.

Purpose

The procedure addresses the issue of dislocating peroneal tendons, which can cause pain, swelling, and ankle instability. The goal is to restore the normal position of the tendons and enhance ankle stability, thereby reducing pain and preventing future dislocations.

Indications

• Chronic ankle instability
• Recurrent dislocation of the peroneal tendons
• Pain and swelling on the outer side of the ankle
• Noticeable snapping sensation around the ankle

Preparation

• Patients may need to fast for 8-12 hours before the surgery.
• Medication adjustments may be necessary, particularly for blood thinners.
• Imaging studies like X-rays or MRI scans might be required to assess the extent of the issue.

Procedure Description

1. The patient is placed under general or regional anesthesia.
2. An incision is made on the outer side of the ankle to expose the peroneal tendons.
3. The fibula bone is cut (osteotomy) to create a path for the tendons to be securely repositioned.
4. The tendons are then placed in their correct anatomical position.
5. The fibula is repaired and stabilized, often with screws or plates.
6. The incision is closed with sutures or staples, and a bandage is applied.

Duration

The procedure typically takes around 1-2 hours.

Setting

This surgery is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technicians

Risks and Complications

• Infection at the surgical site
• Nerve damage leading to numbness or tingling
• Poor wound healing or scarring
• Blood clots
• Recurrence of the tendon dislocation
• Pain or stiffness in the ankle

Benefits

• Stabilization of the ankle joint
• Reduction in pain and swelling
• Prevention of future tendon dislocations
• Improved mobility and function of the ankle

Recovery

• Patients may need to wear a cast or boot for several weeks.
• Weight-bearing on the affected foot might be restricted initially.
• Physical therapy will be crucial for regaining strength and mobility.
• Full recovery can take several months, with gradual resumption of normal activities.

Alternatives

• Non-surgical options like physical therapy, bracing, and anti-inflammatory medications.
• Minimally invasive surgical techniques, if the condition is less severe.
• Pros and cons of alternatives include shorter recovery times but potentially less permanent solutions.

Patient Experience

During the procedure, anesthesia ensures that the patient feels no pain. Post-surgery, pain management will include medications and possibly the use of ice and elevation to reduce swelling. Discomfort is expected, but will gradually decrease as healing progresses. Regular follow-up appointments will monitor recovery and address any complications or concerns.