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Scar tissue build-up and fluid in tendon

Posted by Terri on 6/26/04 at 10:54 (153982)

Hope the dr's can suggest some treatments on this:

Had TTS release on right foot Jan 2004. The incision separated slightly resulting in a 1/2' wide scar. I wasn't happy with my 1st dr's follow-up regarding my questions about pain, etc. so had a 2nd opinion done in April. An MRI was ordered and found significant scar tissue build-up now pressing on the nerves again and the tendon running up the inside of the foot to the calf is inflamed and there is a 'significant amount of fluid' (quoting the dr here) where he will not inject any type of cortisone because he is afraid of 'blowing up the tendon by injecting any more fluid into it'.

My 1st dr cut the nerve leading to the heel, so now I have a permanent numb area there but am recently feeling occasional sharp pains in that same heel. He wanted to cut the p.f. too but I told him not to touch it. The MRI shows he left it alone. Still feeling a tight, pulling sensation from my middle arch to the back of the heel when I pull my foot up towards my shin. I continue to have p.t. and exercise 4 days/week, doing calf presses which helps the stiffness from gaining on me.

The 2nd dr has told me surgery is my only option due to the amount of scar tissue and he will also have to work on the tendon. He wants to make an incision that will start about 5 inches above the ankle, on the inner calf of my leg, that will extend down to my arch.

I REALLY don't want any more surgery! Is there anything else that can be done to get rid of the scar tissue that's wrapped around the nerves without damaging the nerve itself? How can I get this fluid build-up in the tendon to dry up?

On a personal note: Dr. Z and Dr. Ed, we really appreciate the time you take on this board to help us out and answer questions or suggest treatments to ask our regular dr's opinions on. I'm sorry to see some of the comments made by a rare few who have lost sight of what this message board is really here for.

Re: Scar tissue build-up and fluid in tendon

Ed Davis, DPM on 6/26/04 at 13:00 (153987)

Injections of steroids can damage the tendon but not hyaluronidase, an enzyme that breaks down scar tissue. That is something to consider. I am not clear as to what the 2nd doctor wants to do to the tendon, other than, possibly removing as much scar tissue from around it as possible.
Ed

Re: Scar tissue build-up and fluid in tendon

Terri on 6/27/04 at 16:27 (154045)

Thank you Dr. Ed for the fast reply. I'll ask my dr about the hyaluronidase.

He wanted to operate on the tendon as it extends into the calf area mainly as an exploratory measure I think. He really isn't sure what's going on in there, the MRI couldn't show him what he needed to see, I don't know if that's due to the amount of fluid in it or not. Further down into the ankle and foot, there is scar tissue around the tendon too.