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August 21, 2001
Question:
I was diagnosed with Bilateral Flexor Hallucis Longus Dysfunction back in Aug. of 1988 and the DPM suggested operative tenolysis. The MRI showed abnormal increased signal intensity in the synovial sheath surrounding the flexor hallucis longus tendon in my left ankle. With similar findings on the right foot. Imaging findings of a tenogram showed a filling of the tendon sheath moderate irregularity at the musculotendinous function at the level of the ankle, consistent with synovitis. I did get a second opinion with an Ortho following this and that Ortho said that the Xrays in her mind did not show a strong case for the releasing of the tendon, so I went the conservative route the usual orthotics, heat,ice, supports, physical therapy. Basically didnt work, so I have remained sedentary as to not cause a flare up, because any exercise will cause a quite degree of pain. However, know I would like to look into it again, since I used to be very active and hoping this procedure might work, however I heard that this is a very rare condition,I have looked over the internet and could not fine much info except for the packet my doctor gave me Dr Oloff. I am kind of reluctant to have it done thinking I might be better off to be able to walk then not after surgery, feeling that this procedure might make it worse off. If you can please tell me what is the success rate on this type of surgery? What are the risks of this type of injury? What will happen if I dont do anything?
Doctor's Reply:
This is in fact a rare condition. Over time the tendon will become weaker and there is a risk of rupture. Recovery time from such an operation may be three months or more. Risks are infection, rupture of the tendon and loss of some ankle joint motion upward.Movement of the big toe can also be affected. If you have not been doing calf stretching exercises you should consider that. You may also find that you are more comfortable wearing a shoe with an inch of heel height.
 Kirk Koepsel, DPM
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