2013-09-25 / Healthy Living

Surgery restored foot and quality of life

BY KALI LYNCH
Lee Memorial Health System

A foot deformity plagued Lesley Newman for seven years. A result of multiple sclerosis, her right foot dropped, causing her to adjust her gait, which led to pain, trips and falls. Podiatrist Job Timeny, D.P.M., performed surgery that helped Ms. Newman regain the use of her foot.

“Drop foot occurs because of weakness or paralysis of the muscle group in charge of lifting the front part of the foot while walking,” Dr. Timeny explains. “The deformity can affect anybody at any age and there are many causes — including traumatic injuries and a wide range of neurological conditions.”

Dr. Timeny says patients with drop foot learn to compensate by lifting their knee higher than usual in order to keep their foot from dragging on the ground. They also tend to shift the weight of their body to the opposite side when moving the affected limb forward. “The change in proper flow of gait causes the patient to complain of hip pain, spasms in the back of the calf and sometimes in the back of the knee of the affected side,” Dr. Timeny says. “With time and without proper treatment, the patient can develop arthritis in the hip.”

Ms. Newman’s hip pain and spasms became progressively worse and she relied on muscle relaxers and pain medication. “I knew I had to do something,” she says. “It got to the point where I felt like I had nothing to lose. I was worried about the recovery from surgery, but I felt like I had to go through with it because I was in so much pain and didn’t have a lot of function in my right foot anyway.”

There are many different procedures, Dr. Timeny says, and choosing the right option should be determined by the patient and the podiatrist. “The choice of procedure depends on the flexibility of the ankle and the surgeon’s comfort level with a particular procedure,” he says. “The common surgery performed for drop foot is posterior tibial tendon transfer, which involves harvesting a tendon from the bottom of the foot and rerouting it to the top of the foot. With time and physical therapy, the tendon learns to not keep the foot down, but to bring it up while in motion. In severe cases, ankle, or both foot and ankle, fusion may be necessary.”

Dr. Timeny adds that foot and ankle braces are available and are another option for patients who are not good candidates for surgery or for those who choose not to have surgery.

Ms. Newman was able to get back to work five weeks after surgery. “I was back to normal,” she says. “I was able to drive and walk — I didn’t need crutches, a cane or a walker. The surgery dramatically changed my life — it is great to be able to get around without pain or assistance.” ¦

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