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Is surgery necessary for a split tear of the peroneus brevis tendon?

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  #1  
Old 30th April 2011, 05:26 AM
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Default Is surgery necessary for a split tear of the peroneus brevis tendon?

Hi, I had a fall on January 17, 2011. I ended up having a fracture in my malleolus and having minimally displaced bone fragments from my talus. I had a cast for six weeks and was on a cam walker for six more weeks. However, after 12 weeks my ankle was still swelling and very painful. The doctor finally ordered an MRI. The MRI shows a split tear in the peroneus brevis tendon. My doctor says that I need surgery to repair the tear. He says that these tears do not repair themselves. Is this true? Is this necessary?
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  #2  
Old 30th April 2011, 04:26 PM
rdizzy1223 rdizzy1223 is offline
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Apparently from what I've read doctors want these types of tears fixed as soon as possible as the longer you let them go, the worse they get, not better.
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Old 1st May 2011, 12:14 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Thank you rdizzy 1223, I appreciate the response.
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  #4  
Old 17th May 2011, 03:51 PM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I fell in 2006 and had the exact condition you described. I walked in pain until last December, when the ankle started to give out on me. I'd step down and there was no support in the ankle. I was lucky that I did not fall and injure myself further. The surgery, othroscropic bone fragment removal and split tendon repair, was completed on 4/6. I'm recovering and look forward to walking without pain on a strong ankle.
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Old 18th May 2011, 01:57 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Ok, so I decided and went ahead with the surgery. It was performed on May 12th and it turns out I had a full tendon split in length and width. The Doctor was surprised it was not reflected on my MRI. I am now recovering. The first three days were extremely painful and I had to be on painkillers. It has been six days since my surgery my sutures will be in for another 8 days. I am in a half cast and will get a full cast after my suture removal for 4 more weeks. I still feel severe pain when I use my crutches to walk. Has anyone had this similar pain after surgery. How long has your recovery taken. Just curious.
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  #6  
Old 26th May 2011, 06:17 PM
annamarie
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

i to hav a split tear in peroneu brivis tendon i surrfer with bad swelling and pain i hav been like this for over a year steiroids injection worked great gave me back a normal ankle so to speak but if when they wore off id be in worse pain then befor now i hav no choice but to hav op next week . im going on hoiladay in sevenweeks i asked my doc he said fine as il be in a walking boot from day one off op and after four weeks from op i should be walking no probs on it now that im reading about all ur coments im worried he might hav mislaied me please tel il be walking even slowly after op
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Old 3rd June 2011, 02:09 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Annamarie, I just had the surgery three weeks ago. It turned out that my tear was all the way through the tendon and much larger than it appeared on the MRI. The incision on my ankle is about 4inches long. I had a half cast for the first two weeks and now I have a full cast on for the next 4 weeks. The first three days after the surgery, I was in a lot of pain. I honestly did not expect it. My doctor says that after the six weeks in a cast, I will need a walking boot for two weeks and physical therapy. She says that it will take around four months for me to get back to my usual full activities. I hope after all of this it will be worth it, only time will tell.
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  #8  
Old 6th June 2011, 02:35 AM
annmarie
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

omg im in a walking book at the min im pre op hoping to hav it done on fri may i ask what way u were befor ur op how bad had ur ankle got iv been told its a split tear im still in same pain as i was befor so hoping it has not became worse i can still walk ok and hav a good bit off movment i hav bad and good days but hoping its not going to be worse when they go in as he has said i wont need cast can any one tell me what their syteams were like befor op so i can tell if mine is as bad
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  #9  
Old 6th June 2011, 04:38 PM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

annmarie, Sorry I did not reply sooner. Did you have your surgery? Before mine I was able to walk with pain. Please let me know how you did after surgery.
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  #10  
Old 9th June 2011, 11:05 PM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

next fri now my doc is on hols wish it was over but will post how im doing yes i walk fine some days and then limp others night time when im trying to sleep for some reason hurts alot hes still insisting i wont be put in cast so hears hopeing i do know il hav a walking boot but im in one offf those allready allso did u hav much movment in ur ankle as in moving foot inwards or outwards thats haping to me now allso i find along outside of foot under ankle bone is very sore runing right along outside off foot and sometime my toes if i wiggle them very strange but other days its grand but do notis im havin more bad days then good were be for id hav more good so i think its worseing just wish it was over i need four weeks clear befor hols i dont mind walking boot how are u know how many weeks post op are u and what progress hav u made
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  #11  
Old 3rd July 2011, 02:23 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Annmarie, Sorry I had not replied. I went on vacation and just returned. I had the surgery as you know and I had my cast on for 6 weeks. I just got it off yesterday. My ankle and foot are still very swollen. I am in a walking boot for the next for weeks. I am in a lot of pain. It is extremely painful to bear weight on my foot. Everything hurts. I need to start PT and I have been told that is also painful. Please let me know, what your experience has been like. My doctor says that I will be able to go back to my regular activity in six months.
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  #12  
Old 7th July 2011, 01:06 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

hi im four days post op and no pain im up walking from two days post op onece the boot is on im up and about swelling gone only thing is the pinching off the stiches they come out next friday they had me weight bearing after syugery but to be hounest i sad no went home and kept it up tryed bearing weight next day just a little buy day two i was walking normal in boot i still rest it alot dont want to do more damage but im doing ok boot for four to six weeks but iv had that boot for eight weeks pre op so thats not to bad i had the tenon repair and a clean out off scar tissu only thing im not happy with is lenth off scar its long but im doing good hope u are to
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  #13  
Old 12th July 2011, 01:35 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Hi, unfortunately my situation has gone from bad to worse. I finally got my cast off and when the Doctor say my foot she said that it did not look right. My foot was a blue purple in color and very swollen. When I put weight on it I want to scream in pain. She sent me to a pain management doctor and they both are in agreement that I have CRPS (Complex regional pain syndrome), it is a condition that happens to you after a trauma. Your nerves feel like they are constantly on fire and the pain in very strong. No cure, just pain management. It can last for a while or forever. Not enough studies done to see how it affects individuals.
So tomorrow I go in for a procedure called LSB (lumber sympathetic block). They inject anesthesia through a needle to the nerve in your spine. Blocking the sensation of pain to your nerve and then you go directly to physical therapy so that they can work the heck out of your foot. With CRPS, the main thing is to use your foot no matter the pain. It is a matter of use it or loose it. The pain management doctor told me that if we are not aggressive in treatment, I will not be walking at this time next year. I will keep you posted.
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  #14  
Old 15th August 2011, 03:17 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I am not sure how many people are talking here as there is only one name, but how is everyone doing now after your surgeries?
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  #15  
Old 15th August 2011, 03:25 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

How is everyone doing now? I am scheduled for my surgery Sept 21st. I wonder about how long the recovery time is. How long before you can walk, return to work, drive a car. How ugly is the scar? Does the ankle look normal again or still swollen? How bad was/is the post op pain?
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  #16  
Old 19th August 2011, 09:02 PM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

No answers to questions so I hope that is a sign that everyone is doing well. My surgery has been moved up to Aug 26th. I ordered the seated knee scooter yesterday so that I will be able to get around during the non-weight bearing stage and maintain some independence. Set up here at the house to work from home as much as possible. Hoping to heal fast and praying for no complications as posted in #13.
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  #17  
Old 30th August 2011, 08:26 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I didn't have a split in my tendon but I did have a peroneal tendon debridement and cleaning out of scar tissue. I had surgery almost 3 weeks ago. I was in a half slab cast for 2 weeks, NWB, and now am in a cast for another 2 weeks, also NWB. I will then go in the boot, but not sure how long.

The pain was a bit more than for other surgeries, but percocet took care of it. I can't sit with my foot down for very long as it swells, etc. and the incision burns.

The incision went from the top of my ankle bone and down to the bottom edge of my foot, and then along towards the front for a couple inches. 17 staples long. It was very swollen at the 2 week mark when I got the cast on, and very very bruised.

I am supposed to get the boot in 10 days when I go back, and expect that I will be PWB for a few days for sure until my foot gets used to things, then FWB without crutches, wearing the boot. I have no idea how long I'm in the boot, but my job entails me being on my feet most of the day (work in a school), so I may need it for work even if I don't at home. Or maybe a brace, don't know. Will find out more when I go get this cast off...!

I had surgery on my left foot, so could drive right away, but didn't until I got the half-slab off and the cast on as my foot felt too vulnerable. Worried about falling or hitting it or something. Stuck close to home the first two weeks.

I didn't use the knee scooter -- just used crutches. I'm really good on them now after being on so much after breaking my foot and having it take over 10 weeks to heal ... then having the tendon issues on top of it.

I think I'll have to trash the boot when this is done though as the liner has almost had it! And the velcro is almost worn out! lol

Good luck with your surgery.
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  #18  
Old 29th October 2011, 06:51 PM
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Smile Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

My left ankle go so bad that I could hardly walk. I consulted with three doctors, total.
The first had an x ray of my foot and ankle made and the picture showed no misalignment
or other problem. The second doctor ordered an MRI, whicH showed that my main foot
tendon was split. He sent me to an orthapedic surgeon who verified the MRI reading. He
said that he did not recommend surgury because it was painful, took a long time to heal,
and he could not guarantee the results. He wrote me a prescription for a leg brace He
said I would have to give up my wingtip and running shoes. I decided to try wrapping my
foot and ankle. Since then, my swelling, which I had had for months, is gone and I have
no pain at night. In addition, I can walk without pain. None of the three doctors even
mentioned wrapping of my foot and ankle. I rememered that athletes wrap their ankles
before and after an injury. DON NEAL FROM SOUTH CAROLINA.
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  #19  
Old 4th July 2012, 12:27 AM
Doug
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Unhappy Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

You all are scaring me! I recently inured my left foot, and my mri showed a split tear of the peroneus brevis, and short longitudinal tears of my achilles in addition to a mid anterior calcaneal cyst that was preexisting. I'm in a full cast now, but haven't had surgery. My doctor wants to use that as a last resort. Listening to everyone here, it sounds like surgery it's almost a given! Wish me luck!
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  #20  
Old 6th July 2012, 02:41 AM
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Red face Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I just found out today that I need surgery. I have a split tear of the peroneus brevis tendon. Doc says only 17% heel with just booting. Because I can't do surgery for another month I decided to boot until I am ready. The surgery stories sound horrible. has anyone not gone through with the surgery and just dealt with the pain? I have been in pain for 4 months because I was too pig headed to get it checked out. I tolerated. However the thought of not hiking, biking, swimming, or running on the beach leans me towards surgery. I have two young kids to chase after too. Ugh! Good luck to u Doug. I hope your surgeon steers you in the right direction.
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  #21  
Old 29th July 2012, 10:04 PM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I had surgery in June for multiple tears in my Brevis Tendon related to degenerative processes. I am 35 and my doc told me that he was suprised to see the damage I had. In Oct I had a complete rupture of my plantar fascia on my L foot. A couple of months after this I was having a lot of lateral column pain and lateral ankle pain on my lft foot. My podiatrist at that time would just blow me off when I would bring it up. I ended up switching podiatrist. He had order an MRI which showed the tear, but when he got in there it was worse than he thought so he had to repair the tears and then attached the brevis tendon to the longus tendon. I was in hard cast for a week then camboot for 2 weeks with non-weight bearing. Then camboot for 4 wks after that. I still have pain in my L ankle and swelling. I cannot walk on uneven surfaces if so I cannot walk. I am a nurse and had went back to work after 3 weeks, which sucks since I am on my feet a lot. I would like to know if other people about 8 wks out still have increased pain and swelling.

Thanks
Tam
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  #22  
Old 6th August 2012, 07:57 AM
Doug
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Finally was ordered to have surgery. August 17th is my date. I can't walk without pain with my boot. They cut my cast off last week and didn't put on a new one since I'm having surgery in less than 2 weeks. I'll part again after surgery. For anyone going through this, I can definitely tell you that you do need surgery! I originally ruptured my brevis tendon 6 years ago playing soccer. Had a combination of hard cats and walking boots for 6 months. 6 years later, it's happened again. I was told that if I would have had surgery the first time that this wouldnt have happened a 2nd time!
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  #23  
Old 10th August 2012, 05:00 AM
grandma's foot grandma's foot is offline
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

It sounds as if others share some of the frustration that I have in trying to obtain effective treatment for this tendon tear. I was initially diagnosed by MRI in Dec which was confirmed by dynamic ultrasound in Apr. It is now Aug and my ankle is no better having encountered numerous delays along the way and having received conflicting opinions as to whether such a tear ever heals on its own or whether surgery is always indicated. In attempt to "heal" this I wasted 3 mos awaiting Southwest brace to be made which still didn't properly fit after 3 molds had been done for which insurance was billed $4800! There were multiple delays from the manufacturer and I am befuddled as to why the certified "fitter" didn't take initiative to contact the surgeon re: need of interim plan instead of repeatedly telling me it'll be here "next wk". I called the surgeon's office and was improperly adviced by the front office staff to reschedule my appointment as I hadn't been wearing the brace. I am now in camwalker which so far has not made the ankle feel any better. I fail to understand why trying to obtain treatment is so difficult!
I guess what I'd like to know is whether anyone has had successful surgical repair, as the process sounds daunting. Or if anyone has had a successful heal with immobilizing the ankle. Thank you.
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  #24  
Old 15th August 2012, 11:52 PM
crconlee crconlee is offline
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Unhappy Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I will tell you about my experience and maybe it will help you. Two years ago i awoke in the night with severe pain in my foot in front of the ankle bone. An x-ray showed nothing so they gave me a shot of anti-inflamatory medicine and sent me home. My husband was in home Hospice care so I manged through until his death. Since then I have been to 8 doctors, an MRI, CAT scan, 6 weeks in a knee high cast, three times in a soft cast, steroid shots and PT. Nothing helped. I finally searched the internet for the best foot and ankle specialist in the Chicago area. He ordered a muscular/skeletal ultrasound which finally showed the longitudinal tear in the brevis tendon.

The doctor told me 50% of people could be helped by PT to have the other tendons learn to take over for the Brevis. He also said that if I had surgery it would be 6 weeks with not touching my foot on the ground at all. I went for PT and the therapist said he didn't think PT would work.

I went back to my original foot and ankle specialist (orthopedic) and he concurred that pt would not fix it as none of the methods I had used before worked either. That surgery was the only fix, but that I would walk out of surgery in a soft cast.

Now I don't know what to think. Surgery or not? Walk after surgery or not?
So......I came to the internet to find out what I could find. My search has led me to believe that surgery is the only answer. I am still wondering about post op recovery. I am a 66 year old diabetic and I want this foot to heal the first time.
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  #25  
Old 15th August 2012, 11:55 PM
crconlee crconlee is offline
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I will be anxious to hear about your surgery and how recovery goes for you. My prayers will be with you.
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  #26  
Old 31st August 2012, 01:36 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I am getting ready to have surgery done on my left foot for a tear in my brevis and longus tendons. I have been and a walking boot for two weeks now to see if that would work to heal it but it has not. So I have agreed to surgery before the problem gettings any worst. My doctor is not sure when I might have torn the tendons because I have been in pain for about ten years now and ever doctor I saw at first just blew me off. Than I feel again last month and the dostor believes that I causer more damage to the tendons because I am in alot more pain now. But I am not sure what to expect because it seems like everyones after surgery plan was different. Some of them got hard cast some only got the boot. Some people were in lots of pain and some were just fine. I just wanted to know if anyone else has had to have both tendons repaired at the same time like I do? Thank you!!!
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Old 5th September 2012, 03:17 PM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Hi, I had surgery after 6 months of pain. That was june 2011. I have done all that was required of me by the physio's and more. However the surgery was not successful - the rate for success is 80% for 20% against. I now have the option to do nothing or to graft the Brevis onto the Longis. This also has the same success rate as my previous repair but holds further increased dangers as reguards to infections/thrombosus/pain etc. It is very dispiriting and involves 12 months of recovery to something like normal. I'm not sure as what to do? has anyone had a failed repair and what was the outcome?
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  #28  
Old 17th September 2012, 12:20 AM
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Default Re: Had the tendon surgery this week

Hi folks,
I just had this surgery last week. I have a pic of the incision - not sure if I can post it here, will check after.

My surgery went fine. They used skin grafts and sutures as well as using my own platelets spun from my blood taken on the day of surgery to transfuse into the area to help repair torn ligaments as well.

I have a hard fiberglass cast that has already been changed because it was way too tight. Would you believe the second cast was wet when I got home all over the bottom and up the back? The doctor stated that the material used on the footing of the cast is wet by nature and to 'blow dry' it. Seriously? I did what they said but will call again tomorrow because I am worried about infection from a wet cast.

I was told that I can bear weight right away and am using a walker. Pain is not too bad but trying to keep off my feet as much as possible. Stairs are a challenge. Anyone have any tips on how to deal with those?
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  #29  
Old 2nd October 2012, 12:16 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

Wow! I thought I was the only one...
It is so hard to believe that so many people have the exact same problem. And yet so many varying opinions from doctors.
I am trying to make sense of what to do next. I started having lateral foot pain in April. Went to doc, had MRI, found to have partial thickness, longitudinal split tears in the brevis and thickening, fraying, splaying of the longus.
Wore cam boot and had PT for 6 weeks, no help. Now I have pain behind the ankle bone, achy, comes and goes depending on my activity level. Basically can't do much of anything without paying for it later. Got second opinion and he said no surgery, it was mild case. OK..... now what? So the 3rd guy wants to do cortisone injection.
I am so confused. I think because they are partial thickness? Not as bad?
Any suggestions from anyone?
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Old 4th October 2012, 06:50 AM
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Default Re: Is surgery necessary for a split tear of the peroneus brevis tendon?

I rolled my ankle in Aug of 2011. I thought it was just a sprain. After not getting better I had an MRI which showed a lateral tear of the peroneus brevis tendon. Since it had been 8 mos and it did not heal with time and booting, I decided to go ahead with the surgery as I could not handle walking carefully and hoping not to roll on my ankle causing pain anymore. I had the surgery April 26, 2012. I was in a half cast for 2 weeks and nonweight bearing. When the stitches came out at 2 weeks I got my "ironman" boot. I was then able to begin bearing weight using crutches, progressing to 1 crutch, and then progress to no crutches but continue with the boot and I also started Physical Therapy. I am not going to lie. I was in a lot of pain after the surgery. My foot had to constantly be propped up above my heart due to swelling. I used pain meds and ice. I used Ice even through the night for the pain. When my foot would hang down it would swell and throb. I heal very slowly in general. At 3 mos I was able to walk around at home with no brace at all and just a store bought ankle brace when out with a supportive sneaker. At 5 months I had progressed to being able to walk slowly on the treadmill for 30 min and I could do weight bearing exercises. I still experienced pain - but not the pain I experienced with the original tear, which was a sharp pain that would make me scream if I turned my ankle the wrong way. This was more of a "I need to give it a break and put it up" pain. I needed to continue gaining strength and endurance for sure. At 5 mos my PT recommended another 6-8 weeks of PT. I used Mederma as soon as my incision was completely healed and you can hardly see my 3 inch scar! The doctor said "If only the inside would heal as well as the outside!" Use Mederma. I scar like crazy. I believe the Mederma made a huge difference. Unfortunately, after 5 mos of progressing, allbeit slowly, I over did it one night while exercising. I had been out of PT for 1 month due to vacations. The following week I re-tore the same tendon in a different spot. All my 5 mos of work down the drain. I knew immediately what I had done. I recognize that pain! Even though I wondered if I was better off since at 5 mos I was still having difficulties - I know now that I was because I cannot handle standing there, not moving, and just lean over on my ankle or twist in just a way that I scream with pain! 2 weeks later I told the Dr I needed another MRI for a possible tear and he said "I'm sure you didn't tear it again". But then again - if its going to happen it happens to me so he agreed. Sure enough...it's torn. I just got the news on Monday. I cried for 2 days. I think I cried knowing what I have to go through all over again and how painful and difficult it is to be incapacitated for so long. Oh and yes it is my right foot. I have not driven in a year! I have to rely on everyone else and I live in a 2 story home making it very difficult to get up to bed at night if no one is here to help. I have a trip planned in 4 weeks to Vegas. Oh well - trying to think positive. At least I know its torn. The doctor put me back into a walking boot for a month and crutches if needed for long walks. Had I gone to Vegas with just my store bought brace not knowing it was torn and I positive I would have completely blown it out and ruined my trip. At least with the boot I am pretty confident I will not do any harm to it. I am going to bedazzle/bling out my boot and my crutches for Vegas! I see the doctor Oct 30 and we decide on surgery then....if it doesn't heal on its own which we all know it won't. I have been dealing with this now for 13 month and I am pretty down BUT its not the worst thing in the world. It's not cancer and we can all heal from this. It is not a death sentence just a major inconvenience. My PT told me that you need a high protein diet to help promote healing. I also take Vit D and Vit C to help. I will be buying some Calcium also to begin. My problem may be that I take inhaled corticosteroids to treat my asthma. But I have to breathe so.....I do it. My recovery as been 5 mos so far since surgery. Online it said 4-6 mos generally. I take about double so I think I was doing pretty well. Hang in there everyone! And DO NOT overdo it or you will wind up like me. Going back for Round 2!
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