RE: tendon transfer surgery

[Guest guest]

My son just had the ATTT on 10/28/03. Not sure I can answer your

question, though, since he is still in casts.

Bonnie B.

wife to Jack, 5/3/92

mom to Zachary, 8/3/93,

, 12/29/97, and

Dylan, 10/26/00-bilateral CF, ATTT-10/28/03, last casts off- 1/01/04

Happy Holidays!

On Sat, 13 Dec 2003 16:31:43 -0000 " srchace " writes:

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

A few of you have been talking about this surgery. What is it? At around what

age is it done? Why is it necessary?

[Guest guest]

,

My son is scheduled to have the surgery this Thursday. I will make

sure to post information on how he is doing, hopefully this will help

you. If you want feel free to email me, and I can try to answer

anything I can privately.

Good Luck,

Barry

> Has anyone had their child go through with the lateral transfer of

> the anterior tibialis tendon surgery? What are the short and long-

> term results?

> Thanks,

>

[Guest guest]

Hi ,

Emma had this surgery on November 12 in Iowa, by Dr. Morcuende. It is very

minimally invasive, but we found the procedure to be very hard on her. The

problem was in the post-surgery pain management. For two days (or more!)

Emma barely slept, continually waking in jerks or spasms of movement and

pain. She was on her max for morphine the first day, and then other drugs

on top of it. The pain and muscle spasms in the post-op casts took 2 weeks

to really go away. Since then she has been fine. From a conversation we

had with Dr. Morcuende today he said that these casts can come off after 5-6

weeks. Six weeks was what we were originally told, so we are going to take

them off just a few days before that so she can stretch a bit before

Christmas.

We were told by Drs. Morcuende and Ponseti that this surgery is a very good

fix for relapses of clubfoot, to correct heel varus and metatarsus adductus.

The positive side is that the child does not need to go back into the FAB.

Because no muscle tissue is cut there is no internal scarring, and so no

pain as the foot grows. The success rate is very high, but I have no

numbers to give you. We were told that in rare cases the tendon can become

unattached and they would have to go in and reattach it. This occurred when

they used a different type of stitch to hold it under the foot instead of a

button.

We were also told that it would take some time for the brain to learn how to

process the new location of the tendon, and so the gait may take some months

to properly adjust.

Hope this answers some of your concerns,

- & Emma

18-10-99

tendon transfer surgery

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

,

Thank you for sharing this with us. I'm sure it has been a very

stressful time for your family. I'm glad to hear that Emma is feeling

well now and, perhaps, this will be the end of her clubfoot correction!

Best Wishes,

Amy

> Hi ,

>

> Emma had this surgery on November 12 in Iowa, by Dr. Morcuende.  It is

> very

> minimally invasive, but we found the procedure to be very hard on

> her.  The

> problem was in the post-surgery pain management.  For two days (or

> more!)

> Emma barely slept, continually waking in jerks or spasms of movement

> and

> pain.  She was on her max for morphine the first day, and then other

> drugs

> on top of it.  The pain and muscle spasms in the post-op casts took 2

> weeks

> to really go away.  Since then she has been fine.  From a conversation

> we

> had with Dr. Morcuende today he said that these casts can come off

> after 5-6

> weeks.  Six weeks was what we were originally told, so we are going to

> take

> them off just a few days before that so she can stretch a bit before

> Christmas.

>

> We were told by Drs. Morcuende and Ponseti that this surgery is a very

> good

> fix for relapses of clubfoot, to correct heel varus and metatarsus

> adductus.

> The positive side is that the child does not need to go back into the

> FAB.

> Because no muscle tissue is cut there is no internal scarring, and so

> no

> pain as the foot grows.  The success rate is very high, but I have no

> numbers to give you.  We were told that in rare cases the tendon can

> become

> unattached and they would have to go in and reattach it.  This

> occurred when

> they used a different type of stitch to hold it under the foot instead

> of a

> button.

>

> We were also told that it would take some time for the brain to learn

> how to

> process the new location of the tendon, and so the gait may take some

> months

> to properly adjust.

>

> Hope this answers some of your concerns,

> - & Emma

> 18-10-99

>

> tendon transfer surgery

>

>

> Has anyone had their child go through with the lateral transfer of

> the anterior tibialis tendon surgery?  What are the short and long-

> term results?

> Thanks,

>

>

>

>

>

>

[Guest guest]

Were you able to find any research on the specifics of the surgery? I can't

seem to find much on ATTT. My daughter is also getting the tendon on the bottom

of her foot released as well. We are in Seattle. Is Ponseti your doctor?

Cheers,

Re: tendon transfer surgery

My son just had the ATTT on 10/28/03. Not sure I can answer your

question, though, since he is still in casts.

Bonnie B.

wife to Jack, 5/3/92

mom to Zachary, 8/3/93,

, 12/29/97, and

Dylan, 10/26/00-bilateral CF, ATTT-10/28/03, last casts off- 1/01/04

Happy Holidays!

On Sat, 13 Dec 2003 16:31:43 -0000 " srchace " writes:

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

Thank you for your e-mail. My daughter Sophie is scheduled for surgery in Jan.

I'm trying to get info beforehand. Were you able to find research on the

specifics of ATTT? I can't seem to find much on it, just on the non-surgical

castings, which Sophie went through. Sophie will also get the tendon on the

bottom of her foot released as well.

The ATTT seems so severe considering her bones are in correct alignment and you

wouldn't be able to tell that she has a club foot from the x-rays. Her doc

doesn't believe that releasing the bottom tendon will help. Did you have

similar conversations with your docs?

Is the gait problem typical or just in rare cases?

Thanks,

tendon transfer surgery

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

,

There isn't much on the net about the ATTT. Dr. Ponseti's book gives a

detailed account. The procedure basically involves moving the tendon over to

the third cuneiform which is roughly 1 cm from where the tendon is presently

attached.

Which tendon are you referring to when you mention " the bottom tendon " ?. If

it is the achilles tendon then releasing it is not recommended unless Sophie

has lost all dorsiflexion. I believe that even at 0° the doctors in Iowa

don't do anything about it. You also say that Sophie will have the bottom

tendon released but the doctor feels that it won't help. I'm curious about

why he will do it anyway.

As for the gait to adjust, it's typical after this surgery--it won't be any

worse than before the surgery.

One last thing, if her foot is looking pretty good as it is, it may be

correctable with casts only but she would then need the DBB for another

year. Dr. Ponseti said that if Emma's feet had been a little better he would

have tried to correct her feet without the ATTT.

Re: tendon transfer surgery

Thank you for your e-mail. My daughter Sophie is scheduled for surgery in

Jan. I'm trying to get info beforehand. Were you able to find research on

the specifics of ATTT? I can't seem to find much on it, just on the

non-surgical castings, which Sophie went through. Sophie will also get the

tendon on the bottom of her foot released as well.

The ATTT seems so severe considering her bones are in correct alignment and

you wouldn't be able to tell that she has a club foot from the x-rays. Her

doc doesn't believe that releasing the bottom tendon will help. Did you

have similar conversations with your docs?

Is the gait problem typical or just in rare cases?

Thanks,

tendon transfer surgery

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

The bottom tendon I'm referring to is the abductor hallucis tendon. When Sophie

tries to point her foot and toes up and out, that tendon keeps it from going

laterally. Her doc wants to snip it just under her big toe to allow her foot to

move. It will regenerate just like her achille's tendon. What is Dr. Ponseti's

book called?

Thanks,

tendon transfer surgery

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

I can't remember the title of the book but it's not easy to come by. You'd

have to write to Dr. Ponseti to get it.

I can give you some details that I know from what Emma went through. Two

small incisions will be made on the top of the foot. After the tendon is

cut, a small hole is drilled in the 3rd cuneiform at the top of the foot.

The tendon will be attached there and held in place by stitches. That's

about all there is to it. The procedure including casting takes roughly

20-25 minutes per foot. I'm sorry I couldn't tell you more.

I should also mention that Emma had a hard time at first because the

epidural they gave her didn't take. Normally, the second day is toughest

according to the doctors. Her casts will come off in 3 days so we'll give

you more details then.

Re: tendon transfer surgery

The bottom tendon I'm referring to is the abductor hallucis tendon. When

Sophie tries to point her foot and toes up and out, that tendon keeps it

from going laterally. Her doc wants to snip it just under her big toe to

allow her foot to move. It will regenerate just like her achille's tendon.

What is Dr. Ponseti's book called?

Thanks,

tendon transfer surgery

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

Actually, I couldn't find very much info at all. Most of the information I found

was on the Posterior release.

Our son's doctor is Dr. Herzenberg in Baltimore, Md.

Bonnie B.

Wife to Jack, 5/3/92

mom to Zack, 8/3/93,

, 12/29/97, and

Dylan, 10/26/00-bilateral CF, ATTT 10/28/03, last casts off on 1/01/04

Happy Holidays!

Re: tendon transfer surgery

Were you able to find any research on the specifics of the surgery? I can't

seem to find much on ATTT. My daughter is also getting the tendon on the bottom

of her foot released as well. We are in Seattle. Is Ponseti your doctor?

Cheers,

[Guest guest]

Thank you for the info. It has been really helpful. We might be flying out to

Iowa to see Dr. Ponseti to get his diagnosis. Have you met him?

Happy Holidays,

tendon transfer surgery

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

Doctor Ponseti and his entire staff are some of the MOST kind, gentle, and

generous people you could ever hope to meet. He has a thick Sspanish accent

and speaks sort of quietly so I find it hard to follow what he says at times if

I am struggling to contain a child (or children) while we speak but that is the

only thing I can think of that you may want to take in to consdieration - like

have someone with you if possible to listen to instructions, but don't be shy to

ask a nurse if you don't understand, either.

.. Have you met him?

Happy Holidays,

tendon transfer surgery

Has anyone had their child go through with the lateral transfer of

the anterior tibialis tendon surgery? What are the short and long-

term results?

Thanks,

[Guest guest]

Does she have to go back into the dbb after the surgery?

> Hi ,

>

> Emma had this surgery on November 12 in Iowa, by Dr. Morcuende.

It is very

> minimally invasive, but we found the procedure to be very hard on

her. The

> problem was in the post-surgery pain management. For two days (or

more!)

> Emma barely slept, continually waking in jerks or spasms of

movement and

> pain. She was on her max for morphine the first day, and then

other drugs

> on top of it. The pain and muscle spasms in the post-op casts

took 2 weeks

> to really go away. Since then she has been fine. From a

conversation we

> had with Dr. Morcuende today he said that these casts can come off

after 5-6

> weeks. Six weeks was what we were originally told, so we are

going to take

> them off just a few days before that so she can stretch a bit

before

> Christmas.

>

> We were told by Drs. Morcuende and Ponseti that this surgery is a

very good

> fix for relapses of clubfoot, to correct heel varus and metatarsus

adductus.

> The positive side is that the child does not need to go back into

the FAB.

> Because no muscle tissue is cut there is no internal scarring, and

so no

> pain as the foot grows. The success rate is very high, but I have

no

> numbers to give you. We were told that in rare cases the tendon

can become

> unattached and they would have to go in and reattach it. This

occurred when

> they used a different type of stitch to hold it under the foot

instead of a

> button.

>

> We were also told that it would take some time for the brain to

learn how to

> process the new location of the tendon, and so the gait may take

some months

> to properly adjust.

>

> Hope this answers some of your concerns,

> - & Emma

> 18-10-99

>

> tendon transfer surgery

>

>

> Has anyone had their child go through with the lateral transfer of

> the anterior tibialis tendon surgery? What are the short and long-

> term results?

> Thanks,

>

>

>

>

>

>

[Guest guest]

My son is 5, he had the surgery when he was 25 months old, performed in Iowa

City and over-seen by Dr. Ponseti. That first night was awful, he reacted very

poorly to the morphine and I couldn't convince the night nurse to take him off

of it and try a different pain killer. Next morning though an older nurse came

in charge and agreed to take the morphine away and use something else

(codeine?). He responded well, stopped throwing up and regained his appitite

allowing us to return to the Mc house later in that afternoon. He

wore the casts for 6 weeks. When they came off it was summer and I took him to a

local lake-beach almost daily after that; walking in the sand and water seemd to

strengthen his legs rapidly and he began to walk normally with in ten days of

their removal (he could hardly walk prior to the operation).

Don't know if any of that helps. It's been three years since the operation and

he's had no further problems.

s.

tendon transfer surgery

>

>

> Has anyone had their child go through with the lateral transfer of

> the anterior tibialis tendon surgery? What are the short and long-

> term results?

> Thanks,

>

>

>

>

>

>

[Guest guest]

That's really good news to hear re: your son's foot. My daughter will be having

her surgery on Tues. Our concerns are primarily long-term problems, if any. I

spoke with Dr. Ponseti by phone and he is very nice indeed. I'll post her

experience next week.

Did you e-mail those articles?

Thanks,

tendon transfer surgery

>

>

> Has anyone had their child go through with the lateral transfer of

> the anterior tibialis tendon surgery? What are the short and long-

> term results?

> Thanks,

>

>

>

>

>

>