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Laciniate Ligament

Posted by SteveWG on 8/21/03 at 11:25 (127512)

I'm about to pull the trigger on tarsal tunnel surgery. How important is the laciniate ligament? Does this ligament 'heal' after being cut?

My doctor, a foot and ankle orthopedist, informed me to look forward to 4-6 weeks in a boot, sutures removed 10-14 days after surgery, maybe back to work in one or two weeks. Realizing each case is unique, does this sound reasonable? Have had one year of conservative treatment without any lasting relief. EMG performed first of May revealed slower conduction in plantar nerve when compared to results of EMG in November. I have seen two different foot and ankle orthopedist and both recommend surgery at this point. Both have given a really positive outlook which seems to contradict much of the literature. Any input is really appreciated.

Thank you,


Re: Laciniate Ligament

Ed Davis, DPM on 8/21/03 at 12:47 (127535)

Return to work within one or two weeks may only be feasible for an individual with a desk job.

The success rate for TT surgery is about 60 to 70 percent. I beleive that the numbers in the literature are very consistent with reality. Only A. Lee Dellon, MD of Baltimore has published higher success rates. One important factor to consider is whether the TTS is related to a space occupying lesion (higher success rate when treated) or scar tissue within the tarsal tunnel. Many of us now try to incorporate elements of Dellon's technique to enhance our success rate -- something to talk about with your doctors.

Re: Laciniate Ligament

SteveWG on 8/21/03 at 15:45 (127565)

Dr. Davis,

I appreciate your comments. That's exactly why my situation seems like such a roll of the dice. MRI and bone scans were both negative. I do not exhibit a very pronounced Tinel's signal except after soaking my feet in cold water. Symptoms, history (new cycling shoes) and EMG tests confirmed the diagnosis. Seems most options have been exhausted.

The physician I'm leaning towards works with professional athletes here in Dallas Texas. I feel he'll be my best bet.