Foot or Ankle Tendon Sheath Cortisone Injection Advice Sheet

Transcription

1 Ft r Ankle Tendn Sheath Crtisne Injectin Advice Sheet 1 Many f the Tendns in the ft and ankle are difficult t islate and inject accurately by feel alne. This is why yu have been brught in t have it dne under X-ray, (Flurscpy) guidance. What is the purpse f the injectin? T surrund the affected tendn with crtisne (dep-medrne), calming dwn the bdies reactin t the damage and try t prmte a healing envirnment. What shuld I expect? It is a daycase prcedure and takes abut minutes t setup and perfrm It is dne in the perating theatre fr equipment purpses, utilising a mbile xray machine Yu will change in t a gwn and travel rund frm the ward n a hspital bed Yu will stay n the ward fr 20-30mins after the injectin t make sure yu are nt having any allergy r immediate drug reactin Yu will be placed afterwards in t a remvable but slid plastic bt fllwing the Injectin fr abut 4 weeks. (An example is the Aircast - XP bt pictured belw) Yu will need an accmpanying adult t take yu hme and be with yu fr the 1 st 12hrs Lcal anaesthetic will be used t numb the tendn area fr 6-12hrs relieving any pain caused directly by this area Once this wears ff the area can be a little mre sre fr 1-2hrs Specialist Ft & Ankle Surgen Clchester

2 2 The crtisne can then take sme 2 days t 2 weeks t take effect and des s gradually What is in the injectin? The tendn sheath (sleeve) will be infiltrated with medical chemicals including a drp f Omnipaque fllwed by dep-medrne and Chircaine mixed tgether. Between 2 & 6mls f fluid in all. Lidcaine 1% - A quick acting lcal anaesthetic that is injected just under the skin t numb the area and allw gentle mvements f the needle deeper twards the tendn t be mre cmfrtable. This is similar t having yur tth numbed at the dentist Omnipaque 240mcg a mild idine chemical dye that shws up n xray t cnfirm the injectin is exactly in the tendn sheath where intended (usualy less than 0.5ml) If yu are allergic t Idine alert the hspital team* Chircaine 0.5% A lcal anaesthetic that can last apprximately 6-12hrs, numbing the tendn and sheath in questin Dep-medrne 40mg A lcally acting crtisne (Sterid) that calms dwn the inflammatin in the area Why d I need a bt? The bt rests the tendn frm its usual functin and is part f the treatment The bt helps prtect the tendn against rupture by reducing the stresses n it, hlding it still What are the risks f the injectin? Bleeding frm the needle prick - Very rare If it desn t stp with gentle pressure then seek medical attentin Specialist Ft & Ankle Surgen Clchester

3 3 Infectin being intrduced by the needle despite ur best care Very Rare This wuld present as redness and pain in the area that slwly deterirates. Yu culd start t feel generally unwell. If it ccurs please seek medical attentin Nerve damage frm the needle prick - Very Rare Experienced as pins and needles r altered sensatin in the ft. It will usually settle after a few weeks. Please highlight this at yur next clinic appintment Tendn Rupture If wearing the bt then very rare During the initial weeks fllwing the injectin this is a recgnised cmplicatin and hence we prtect yu with the bt. Drug reactin frm chemicals used Very Rare If yu get any general symptms feeling unwell, rash, fever r shrtness f breath that deterirate seek medical attentin urgently. **A full list f all ptential adverse reactins is available frm my secretary upn request r using the links belw. Sterid flare - Uncmmn A temprary increase in the symptms that can last 24-48hrs Recurrent symptms The injectin des nt a have a 100% success rate and hence yur symptms dn t respnd r deterirate nce again Feeling Faint immediately afterwards Peple react t injectins in varius ways but wing t this mre cmmn risk yu will return t the ward after the injectin lying n a trlley and be bserved by the nurses fr apprximately 20mins befre leaving the hspital. Full details f the side effect and interactin prfile f each drug are available frm my secretary upn request r by clicking the Links belw. Lidcaine Omnipaque Dep-medrne Chircaine These shuld be hyperlinks please What can I r shuld I d afterwards? Specialist Ft & Ankle Surgen Clchester

4 4 Begin a mental r written recrd f yur experience. Yu are likely t be instructed t use the bt fr 4 weeks The Bt Read Aircast Bt instructins n safe use Shuld be wrn at all times whilst walking fr 4 weeks First 2 weeks Wear the bt day and night at rest as well Secnd 2 weeks Bt can be remved in bed if cmfrtable. Bt can be remved at rest fr a break and when bathing r when changing the supplied sck. Yu can Fully Weightbear (Walk) in the bt whenever necessary* Watch fr any side effects Allergy, Rash, Bleeding r swelling. Alert a dctr if cncerned Rest the ft - This is as much part f the treatment prgram When will I be reviewed? After 4 weeks yu will be seen in clinic and subsequently physitherapy t begin a rehabilitatin prgram. Can I have anther ne? If the first injectin desn t wrk it is unlikely t wrk a secnd time If the first injectin prvides partial r shrt term relief a secnd will be cnsidered but n mre if the same respnse is repeated. This will be discussed mre detail in clinic Driving With the bt n the LEFT ft Yu can drive an autmatic car the next day if yu feel safe With the bt n the RIGHT ft Specialist Ft & Ankle Surgen Clchester

5 5 Yu shuldn t drive a standard car with the bt n 4 weeks and I recmmend making alternative arrangements during this time. Wrk With the bt n yu can undertake sedentary desk type wrk if yur wrkplace are happy N carrying, lifting r prlnged standing is encuraged especially during the 1 st 2 weeks Nte the driving guidance abve Specialist Ft & Ankle Surgen Clchester