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To Dr. Ed.

Posted by Bill on 4/14/03 at 11:28 (116091)

Dr. Ed,
Thank you so much for your reply.

On my most recent MRI, there was evidence that I do have a tiny accessory navicular bone. My doc said that it wasn't contributing to my pain/problem.

As far as my treatment, I have had all kinds of PT, injections, and orthotics over the last 9 years. Nothing has helped.

I had TTS surgery last Aug. 2002 based on a positive EMG showing a nerve entrappment. I had many EMG's over the years that were negative. My surgeon said that he released the upper and lower tarsal tunnel that was being trapped by a very tight deep abductor hallucis fascia. He was positive that this was the area of impingement and the cause of my pain. He said it could take up to two years to feel better.

It is still obvious that my inner ankle is swollen and extremely tender to touch. Any kind of repetitive weight bearing activity aggaravates my pain. I still have the exact same discomfort/pain as I did before the surgery.

My question is can the tiny accessory navicular bone be the cause of my problem?

Re: To Dr. Ed.

Ed Davis, DPM on 4/14/03 at 19:16 (116129)

Bill:
It sounds like your doc has a firm grasp of the TTS aspect.

An accessory navicular bone can be associated with an altered tibialis posterior insertion. If the acessory bone is very small, it may not be significant. Tibialis posterior insufficiency may occur with or without an anomalous insertion. Considering your history, make sure your doc thoroughly works you up for TPD.
ed

Re: To Dr. Ed.

Bill on 4/14/03 at 19:37 (116136)

Dr. Ed,
Thank you again for your quick reply.

How do I know what's the real cause of my pain? If my TTS surgery was a success (according to my surgeon), than why have I not improved after 8 mos?

Could I still have TPD in addition to a healing TTS surgery?

What are diagnostic tests for TPD and how would you treat it?

This has been so frustrating. I have seen many doctors over the years. They all have different opinions.

Also, I live in Chicago now (recently moved from Los Angeles). I've read on this board that the best guy to see here is Lowell Scott Weil, Sr.
Do you agree considering my condition, or do you recommend another doctor.

I really appreciate your advice.

Re: To Dr. Ed. who to see in the Chicago area

Pam S. on 4/14/03 at 21:49 (116146)

I would also like to know who is recommended in the Chicago area. I have been to Dr. Weil Jr. This is a huge practice. There is a very accomplished ortho foot/ankle surgeon named Dr. Steve Haddad who did my TTS release. He does very complicated foot ankle surgery and is well known. What do the Drs think?

Re: To Dr. Ed.

Ed Davis, DPM on 4/17/03 at 18:58 (116450)

Bill:
Lowell Scott Weil, DPM is an excellent choice. I believe that his exam is likely to provide the best answer to your questions.
Ed