© 2016 by JKG Foot&Ankle Surgery.                       Last Update April 2018

NHS Secretary:

Mrs Claire Ellis

Royal Surrey County Hospital

Egerton Road, Guildford

Surrey, UK

 01483 571122 extension 6433​

  • Facebook Social Icon
1/4

Peroneal Tendon Surgery

What are the risks and complications?

The vast majority of patients do extremely well. A small group of patients need extra physio due to swelling or stiffness. Rare complications include infection, blood clots (DVT), nerve damage, tendon injury & failure to improve.

Re-rupture is rare but it can occur.

When can I drive?

The best guide that you are safe to return to driving is that you are able to walk well without crutches. The usual time scale also depends on whether you had surgery on your right or left foot and whether you drive a manual or an automatic

  • Right side and all car types: 6 weeks

  • Left side and manual car: 6 weeks

  • Left side &automatic car: 2 weeks

What can I expect on the day of surgery?

  • The surgery will normally be under a general anaesthetic.

  • Normally this is a day surgery case (unless the surgery is combined with a surgery to realign a bone which is a bigger surgery).

  • I will numb the ankle with local anaesthetic so that you will be comfortable when you wake.

  • There will be a big bandage on your ankle which you will keep clean and dry

  • You will be placed in a removable boot (such as the Aircast boot)

  • You will be given crutches and told to weight bear in the boot with the aid of crutches as needed

Peroneal Tendon Surgery

The peroneal tendons are on the lateral border of the leg, ankle and hindfoot. The tendons have an important role in stabilising the ankle especially on rising up onto tip toes. The peroneal tendons can suffer a variety of trauma including dislocation, splits within the tendon, tendon rupture and the tendons can become 'trapped' by muscle and soft tissue as they wrap around the fibula. Some tendon problems can be improved with an injection and physiotherapy (+++).

 

I am increasingly seeing foot deformities which have occurred due to weakness and loss of function in the peroneal tendons after trauma. If the foot deformity is severe enough, minimally invasive surgery to move the bones into a more normal position is necessary at the same as the tendons are repaired.

 

The peroneal tendons are injuried often together with the lateral ligaments of the ankle. It is common to have an ankle arthroscopy at the same time to tidy up any scar tissue or other problems within the ankle. Sometimes repair of the lateral ligaments is also required.

How long should I take off work?

The time you require off from work depends on what type of job you do. The first two weeks of healing are critical and so you must have this time off work. Many people are able to work from home and so if you can avoid commuting in the first six weeks, you will find that your ankle does better. If your employer can be flexible with your activity at work you may be able to do some lighter duties or reduced hours from 3 weeks onward. If you work on your feet all day, do a manual job, or are required to wear dress shoes you may need 8 weeks before you are back at work.

Instructions for the first two weeks

  1. Elevate Leg Above Heart

  2. Keep dry for two weeks

  3. Keep dressing intact

  4. Please remember that the more time spent standing or walking, the more swollen your foot will be and the worse your healing will be

  5. Partial Weight bear with the aid of crutches in the air cast boot.

  6. You make take the boot off at night and to do your physiotherapy

  7. Physio Exercises: Get your ankle moving! Do the following every waking hour 10-15 times

A)  Alternate the ankle between dorsiflexion and plantarflexion

B) Alternate the ankle between inversion and eversion

C) Draw the Alphabet with your big toe. This will encourage the ankle to move in all directions.

D) Seated Calf Raise

  1. Sit in a chair

  2. Lift your heel as far as possible while keeping your toes on the floor.

  3. Repeat 10 x

AT 2 WEEKS

  • I will arrange to have your sutures removed and to check your wound

  • You will then be able to wash the ankle

  • You should schedule your first physiotherapy session for 2 weeks

 

PHYSIOTHERAPY 2-6 WKS

  • You must continue to use the airrcast boot to stand and walk

  • Continue to work on range of motion but progress to towel or standing stretches

  • Contrast bathing,

  • Wound massage (self) for 3 months

  • Local modalities to reduce swelling

  • Start to work on strengthening

    • Theraband Resistance

    • Cycling on stationary cycle

    • Progressing to double heel rises

    • Swimming, Hydrotherapy

  • Start some early proprioception (balance) work by standing on skipping rope to create a slightly uneven surface

  • Progress to the Surrey Stages to Strengthen Ankle

AT 6 WEEKS

  • I will check your progress in clinic

  • If possible I will let you switch to an Ankle Stirrup Brace

  • I will check your progress with the 'Surrey Stages' Rehabilitation Program

The Recovery after Peroneal Tendon Surgery

Clear Advice About DVT

A DVT is a Deep Vein Thrombosis or a blood clot in the leg. A blood clot occurs after surgery where patients are placed into plaster or a splint for about 2 in every 100 patients. You can help prevent a blood clot by keeping your knee moving. Keeping yourself hydrated is also helpful to prevent a DVT. Finally elevating your leg to the level of your heart will minimise the amount of swelling you have which will also help to prevent a DVT. You will be given blood thinners for the first two weeks when you at your least active.

 

If you were to develop a DVT you would likely have some symptoms and so it is very helpful if know what to look for:

  • The leg (above the dressing/foot) would become hard, heavy, swollen, painful and/or red

  • If you were to have any of the above symptoms you would have to have a scan to look for a blood clot and then be treated with blood thinners

If the blood clot were to move to the lungs you would have a pulmonary embolism which is a medical emergency

  • The symptoms of a pulmonary embolism are breathless & chest pain- Call 911