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Accessory Navicular Excision

Posted by Jennifer T on 7/03/02 at 19:09 (089059)

I had my accessory removed on Monday. The OS mentioned that the tendon was 100 % involved with the accessory. His PA prior to surgery has said that the expectation would be 0 - 50 % involvement. The tendon had to be sutured obviously...how much time might this add to being back on my feet ???????? Would this also be the reason for an increased level of pain post-op from what I expected ???

Thanks for the input.

Jennifer

Re: Accessory Navicular Excision

Dr. Zuckerman on 7/03/02 at 19:21 (089060)

Are you in a cast ? The recovery depends on if you are in a cast.

Re: Accessory Navicular Excision

Jennifer T on 7/04/02 at 00:45 (089083)

No, he didn't cast me, although he had intended to. I am in a mean looking boot which I am to wear when weight bearing (we will see when I am up to that). I am wearing the boot 24/7.

Thanks.

jennifer

Re: Accessory Navicular Excision

Dr. Zuckerman on 7/04/02 at 05:20 (089086)

If you are weight bearing then the posterior tibial tendon had very little repair

Re: Accessory Navicular Excision

Jennifer T on 7/04/02 at 09:46 (089101)

Interesting...the surgeon said that the tendon was in his hand and had to be sutured. I guess I will wait to weight bear until I see him. It might have been all the Dilaudid.

Jennifer

Re: Accessory Navicular Excision

Dr. Zuckerman on 7/04/02 at 19:57 (089142)

Stay off of the foot completely until you talk to him. Usually in a hard cast when the tendon has to be repaired

Re: Accessory Navicular Excision

Dr. David S. Wander on 7/05/02 at 08:11 (089164)

Often, if there is significant involvement of the posterior tibial tendon, the tendon is repaired, advanced, and/or tightened and sutured back to the bone with the use of a soft tissue/bone anchor. This is a device that contains a suture that is passed through the tendon, and a bone anchor that is screwed into the bone for a firm re-attachment. This method usually results in a very secure reattachment and each surgeon has his/her own preference regarding levels of weightbearing. The dressings and removable cast provided may provide adequate protection and immobilization, but as Dr. Z recommended, speak with the surgeon that performed the surgery regarding post op instructions.

Re: Accessory Navicular Excision

Jennifer T on 7/05/02 at 21:12 (089197)

The OS's PA was talking to me about anchors when I went in for the pre-op historyso that is likely what was used. When I had the Tibial Tubercle Transfers to realign my knees, they used screws and they backed out so I had expressed concern and he related the same info about the anchors as you did in the previous post. The PA indicated that this would not be an issue with these anchors.

The issue of weight-bearing or NWB is really not a problem as the foot is still too tender to try it.

I appreciate your advice and insight. I will speak to my OS on Monday and clear the whole thing up.

Sincerely,

Jennifer

Re: Accessory Navicular Excision

Dr. Zuckerman on 7/03/02 at 19:21 (089060)

Are you in a cast ? The recovery depends on if you are in a cast.

Re: Accessory Navicular Excision

Jennifer T on 7/04/02 at 00:45 (089083)

No, he didn't cast me, although he had intended to. I am in a mean looking boot which I am to wear when weight bearing (we will see when I am up to that). I am wearing the boot 24/7.

Thanks.

jennifer

Re: Accessory Navicular Excision

Dr. Zuckerman on 7/04/02 at 05:20 (089086)

If you are weight bearing then the posterior tibial tendon had very little repair

Re: Accessory Navicular Excision

Jennifer T on 7/04/02 at 09:46 (089101)

Interesting...the surgeon said that the tendon was in his hand and had to be sutured. I guess I will wait to weight bear until I see him. It might have been all the Dilaudid.

Jennifer

Re: Accessory Navicular Excision

Dr. Zuckerman on 7/04/02 at 19:57 (089142)

Stay off of the foot completely until you talk to him. Usually in a hard cast when the tendon has to be repaired

Re: Accessory Navicular Excision

Dr. David S. Wander on 7/05/02 at 08:11 (089164)

Often, if there is significant involvement of the posterior tibial tendon, the tendon is repaired, advanced, and/or tightened and sutured back to the bone with the use of a soft tissue/bone anchor. This is a device that contains a suture that is passed through the tendon, and a bone anchor that is screwed into the bone for a firm re-attachment. This method usually results in a very secure reattachment and each surgeon has his/her own preference regarding levels of weightbearing. The dressings and removable cast provided may provide adequate protection and immobilization, but as Dr. Z recommended, speak with the surgeon that performed the surgery regarding post op instructions.

Re: Accessory Navicular Excision

Jennifer T on 7/05/02 at 21:12 (089197)

The OS's PA was talking to me about anchors when I went in for the pre-op historyso that is likely what was used. When I had the Tibial Tubercle Transfers to realign my knees, they used screws and they backed out so I had expressed concern and he related the same info about the anchors as you did in the previous post. The PA indicated that this would not be an issue with these anchors.

The issue of weight-bearing or NWB is really not a problem as the foot is still too tender to try it.

I appreciate your advice and insight. I will speak to my OS on Monday and clear the whole thing up.

Sincerely,

Jennifer