11
Aug
08

Two shoes…and some parting thoughts on the boot

So during my doctor’s visit last Friday he tells me, “It’s time to transition out of that thing.”  That thing is The Boot.  The boot for many–myself included–almost takes on mystical importance in the early days after the ATR. It represents freedom from the cast and a recovery milestone.

Indeed, I did progress during my three and a half weeks in the boot. I went from two crutches to one to none. It was hot and heavy, but I was fortunate I didn’t have any of the incision issues others have battled with. I’m among those who found it a hassle to strap the monstrosity back on to go short distances in the house. I’ve done a lot of hobbling around barefoot.  And yes, there have been a couple of missteps where I’ve seen stars (just last night I stepped in a minefield of kids toys–yow).

Couple of things I discovered…my boot had a big button to pump it up with air and a valve to release the pressure.  I immediately had flashbacks of Dee Brown at the 1991 Slam Dunk contest pumping up his Reeboks. So I filled ‘er up. The support felt good.  Then it got tight. REALLY tight. Turns out when I walked my shin would push up against the underside of the button and continue to inflate it with every step. Deflated, that experiment quickly ended.  Also, the whole mechanism for that button was a pain — literally. I had a nice bruise on my shin until I finally got used to it.

Now it’s into two shoes. My doc told me to have a shoemaker fashion a one inch heel wedge. Picked it up today. Strange. Makes me limp worse I think.  Anyway, PT starts next week and I’m certainly looking forward to it.

P.S. Below is a copy of my operative report.

PREOPERATIVE DIAGNOSIS: RUPTURED RIGHT ACHILLES TENDON.

POSTOPERATIVE DIAGNOSIS: RUPTURED RIGHT ACHILLES TENDON.

OPERATIVE PROCEDURES: REPAIR OF RUPTURED RIGHT ACHILLES TENDON.

ANESTHESIA: SPINAL.

OPERATIVE INDICATIONS AND FINDINGS: At surgery, the patient was noted to have
a complete rupture of the right Achilles tendon. There was this partial rupture of the tendon
sheath of the Achilles tendon. The plantaris tendon was intact.

DESCRIPTION OF OPERATION: With the patient under spinal anesthesia and in the supine position, the right lower extremity was prepped with Betadine and draped in the usual sterile fashion from the toes to the upper calf. An incision was made along the medial border of the Achilles tendon and dissection was carried down through the skin and subcutaneous tissue. Bleeding points were cauterized by electrocautery. The tendon sheath of the Achilles tendon was opened with a Metzenbaum scissor exposing the tendon tear. The plantaris tendon was retracted anteriorly. Minimal debridement of the tendon was carried out. Then a #1 Prolene suture was tied through the tendon in a “Bunnell” fashion and the two ends of the Achilles tendon were then brought into contact. With the splint on, the ankle was kept in the equinus position. Then, a series of horizontal mattress sutures were placed in a circumferential fashion around the tendon tear using #2-0 Vicryl sutures. After this, there appeared to be a secure repair of the tendon in good position. The subcutaneous tissue was then closed with #2-0 Vicryl sutures and the skin with metallic staples. A sterile dressing was applied. The patient was placed in a well-padded short leg cast in equinus. The patient tolerated the procedure well and returned to recovery room in good condition.


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