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Dr. Davis and Dr. Wander

Posted by Debra H. on 4/14/03 at 10:56 (116089)

I'm trying to find a podiatrist that has actually treated a patient that has had an acutely fallen arch following a PF rupture or release. I posted a week ago and Dr. Z answered by informing me that this was a complication of PF releases (I already knew this but I guess it was nice to have this confirmed again) and that it was rare. I really would like to talk to someone that has actually treated someone with this problem so I can get some direction about what my options are. The PF symptoms I had before have resolved, but now I have a whole new set of problems. I believe the biomechanics of my walking has changed. My evidence for this is in my foot print. It use to be a heel and ball connected by a thinner bar. Now they are connected by a bar that is almost as wide as the ball of my foot. placing a lot of strain on tendons / ligaments that are causing tendonitis in various areas. I know how to get tendonitis feeling better (rest, NSAIDS, etc), but my concern is that as long as the biomechanics are wrong, I will continue to develop tendonitis over and over again. I'm looking for a way to interrupt this cycle and actually fix the problem instead of just putting band-aids on it. Can you help me?

Re: Dr. Davis and Dr. Wander

Libby M on 4/14/03 at 13:20 (116095)

I was diagnosed last week with a bone spur in my hip. The doctor perscribed an anti-inflammatory drug.
It showed up on a regular x-ray, which surprised us both.
How did I get it?
How do I get rid of it.
Walking up stairs and sitting is killing me.
What is the next step? I have searched the internet, but I am not getting much info. on 'hip- bone spurs'. It is right in the ball and socket part. Please tell me anything you can.

Re: Dr. Davis and Dr. Wander

Dr. David S. Wander on 4/14/03 at 13:23 (116096)

Surgical repair of a ruptured/released plantar fascia is rare. It is difficult due to scar tissue and difficulty reappoximating the ends of the fascia under the correct tension. Instead, other procedures are utilized to actually increase the arch height via osteotomies (cutting and realigning the bones), tendon advancements/repositioning, bone fusions, etc., all which are relatively involved reconstructive procedures. It is unfortunate that you've experienced this complication. Sometimes, immediately after the rupture the foot is casted with the toes lower than the heel to attempt the area to scar/heal in a shortened position. The problem with this is that you can end up with a tight fascia again, which defeats the purpose of the original surgery. Orthoses are often helpful in providing biomechanical control and support, though you may look at this as a 'Band-Aid'. However, if the use of orthoses works, it can eliminate the need for some major reconstructive surgery.

Re: Dr. Davis and Dr. Wander

Debra H. on 4/15/03 at 01:39 (116153)

Thanks, Dr. Wander, for the honest answer. I will continue to give the orthoses time to work and cross my fingers.