Question
Thank you in advance for your effort in helping me understand what some ankle issues.

Post 5 months surgery to left foot (repair of torn AFTL and CFL, arthroscopy as well).  Left foot is progressing well with physical therapy.  However continuing issues with right foot.  Plantar faciitis for ~1yr - on and off physical therapy to treat - some improvement but recently had MRI for question of other injuries to right foot. MRI indicated "chronic full thickness tear of the AFTL and CFL scar mottled with full thickness discontinuity."  Also peroneus brevis tear and peroneus longus tenosynovitis.  I am prescribed to continue bracing and physical therapy for both feet (ultrasound, massage, stretch, strength, ROM, etc).  How is a chronic full thickness tear different than ligament tears that require surgery?  Is physical therapy standard treatment and usually successful for these types of injuries?  Chronic foot pain has begun to affect my gait and stance which in turn causes lower back pain.  Also worried slowing or reversing healing of left foot with overcompensation for right foot.  Feeling discouraged by the numerous issues as things that help one issue seem to aggravate another (ex. certain plantar fac. exercises cause a painful burning in the peroneal area and up the leg).  

Again I appreciate any information to help me understand what things mean and typical treatment including timeframes (reminding myself to be patient as there is no quick fix).  

Jackie


Answer
Hi Jackie,

Chronic full thickness tear results from a ligament tear that has not healed together.  So you have an abnormal ligament with scarring.  As far as surgery goes, it really depends on the treating dr.  Some will recommend surgery and others more conservative care.I am unable to give you a good answer without seeing the problem and the MRI however, I would seek several opinions prior to any further treatment.  I would certainly see a podiatrist that does a large amount of reconstructive ankle work.  As far as some of the burning along the peroneal area, you could consider cryosurgery to destroy nerves causing pain.  See my cryosurgery site below.


Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

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