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surgery following plantar rupture

Posted by Michelle F on 10/26/03 at 12:21 (135624)

I have not posted for a month or so. In May I had a complete rupture of plantar fascia while supervising a kid's basketball game for school. I'm a school teacher and, fortunately, the medical work and time off has been covered by worker's compensation. The initial injury became a case of tarsal tunnel syndrome... and the fun just hasn't stopped since then.

Two weeks ago we went ahead and had surgery. The intent was to free up the entrapped tarsal tunnel nerve and release the plantar fascia...

Apparently, there was more damage to plantar fascia than expected. DR said that all that was left of the fascia ligament was scattered scar tissue. In addition, reaching the entrapped nerve was more difficult and involved cutting the muscles in my foot. The muscle under the ligament was apparently 2-3 times larger than typical (both much thicker and branching much higher up on top of arch and ankle)and was pressing on the nerve. I used to be an athelete although now I'm a fat, middle-aged, out of shape schoolteacher. I've been given at least three weeks in wheel chair and three weeks after that for leave, but DR has been somewhat sketchy about full recovery and time frames.

Anyway... my questions:
1) Is a full recovery still possible?
2) Is t

Re: surgery following plantar rupture

Michelle F on 10/26/03 at 12:50 (135627)

Blabbing on at length, I must have cut off the questions...
2) How long can I reasonably expect to be _________ ?
... completely off feet
... mostly off feet
... off work
... in pain when standing, walking ...

PS was to say that my DR was really good and incision doesn't hurt... but foot still is messed up and cannot bear any weight without swelling and intense pain.

Re: surgery following plantar rupture

Dr. Z on 10/26/03 at 13:13 (135632)


All of your questions are very good questions. Very very difficult to answer any of these. I have given this type of injury six months plus
to heal. Some of the treatments I use for this injury are casts, physical therapy. and ESWT. I have never used surgery for this type of injury so I can't answer this.
Maybe Dr. Wander has used surgery for this problem in his experience

Re: surgery following plantar rupture

Dr. Z on 10/26/03 at 13:14 (135633)

What prognosis has your doctor given you with regard to these questions

Re: surgery following plantar rupture

Dr. David S. Wander on 10/26/03 at 19:28 (135686)

I'm a little confused as to exactly what surgery was performed. Michelle states that she had a 'complete tear of the plantar fascia', yet later states that the doctor intra-operatively found that it was worse than expected, with only a few pieces of the fascia intact. If it was diagnosed as a complete tear, why would the doctor be surprised to find only a small portion of the fascia intact? Was the original diagnosis made via clinical examination or was an MRI or ultrasound used to determine the extent of the injury?

Once the plantar fascia is torn, I have never known anyone to repair the fascia and reattach it. If there is scar tissue as a result of the injury, I have surgically released the scar tissue, which is in effect, performing another release of the fascia. As far as the muscle that Michelle's doctor states was 2-3 times the size of normal, I'm not sure what muscle he's referring to. It may be the abductor hallucis muscle belly at the area of the porta pedis, where the tarsal tunnel dives into the plantar aspect of the foot. There is no way to determine the muscle involved without more information. Swelling following this type of procedure is not unusual, especially if the doctor had to dissect around the muscle. Once muscle is cut, there is a lot of bleeding and therefore a lot of swelling.

The bottom line is that Michelle must address ALL her concerns with her surgeon, since the surgeon is the only one involved that knows all the specifics of EXACTLY what was performed.

Re: surgery following plantar rupture

Melissa on 10/27/03 at 12:25 (135749)

I think was she had was a tarsal tunnel release. I am in the exact same situation. I ruptured my pf in 6/03 while doing aerobics. Three weeks into the healing I had developed Tarsal Tunnel syndrome. I am now having surgery 11/5 to release the entraped nerve (confirmed by emg). I am concerned that it will be difficult to get the nerve freed from the scar tissue. I wonder what the long term effects are on a torn fascia? will I ever be able to do aerobics again or run?? Good luck on your healing Michelle..