Name of the Procedure:

Capsulotomy, midfoot; with tendon lengthening

Summary

A capsulotomy with tendon lengthening is a surgical procedure that involves cutting into the capsule of a midfoot joint and elongating nearby tendons to improve joint mobility and function.

Purpose

This procedure is intended to treat joint stiffness or deformity in the midfoot, often resulting from conditions like arthritis, injury, or congenital deformities. The goal is to relieve pain, increase range of motion, and enhance overall foot function.

Indications

• Persistent midfoot pain and stiffness
• Limited range of motion in the midfoot joint
• Deformities that affect walking or standing
• Conditions such as arthritis or tendon contractures

Preparation

• Fasting for 6-8 hours before surgery
• Adjusting or stopping certain medications as advised by the doctor
• Undergoing preoperative diagnostic tests such as X-rays or MRI

Procedure Description

1. Anesthesia: Administering regional or general anesthesia.
2. Incision: Making a small incision over the affected joint in the midfoot.
3. Capsulotomy: Cutting into the joint capsule to release tightness.
4. Tendon Lengthening: Identifying and lengthening the tight tendons to improve joint flexibility.
5. Closure: Closing the incision with sutures and applying a sterile dressing.

Tools and equipment include scalpels, surgical scissors, and specialized instruments for tendon work.

Duration

The procedure typically takes about 1-2 hours.

Setting

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

Personnel

• Orthopedic or podiatric surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the surgical site
• Bleeding and swelling
• Nerve damage
• Incomplete relief of symptoms
• Recurrence of joint stiffness

Benefits

• Relief from pain
• Improved joint mobility and function
• Enhanced ability to walk and stand
• Potential long-term improvement in quality of life

Recovery

• Post-procedure instructions will generally include keeping the foot elevated, applying ice, and taking prescribed pain medication.
• Immobilization of the foot in a cast or brace for 4-6 weeks.
• Physical therapy to regain strength and mobility.
• Full recovery typically takes about 2-3 months.

Alternatives

• Physical therapy and stretching exercises
• Orthotic devices to support the foot
• Non-surgical treatments such as corticosteroid injections
• Pros of alternatives: Less invasive, fewer risks.
• Cons of alternatives: May only provide temporary relief or may be less effective in severe cases.

Patient Experience

• During the procedure, the patient will be under anesthesia and should not feel pain.
• After the procedure, patients may experience pain and discomfort, which can be managed with medications.
• Physical therapy may be challenging at first but generally becomes easier as recovery progresses.