Comminuted Calcaneal Fracture With Subtalar Fusion

Mar 5, 2015

I thought I would share my story and healing process as I am recovering from a ladder fall from about 8-9' up onto concrete in November, 2014. I welcome any and all advice and hope my story and (hopefully) regular updates on my own progress will help others who may go through this same event.

On Nov. 30, 2014, I fell from a 10' ladder as I was trying to hang a Christmas wreath above my front door like I had done for the last 14 years! I tried doing this without my wife spotting me on the ladder and, when I reached to try to hang one of the wreath wires, I lost the center of gravity on the ladder and had no option that didn't involve me likely killing myself other than jumping off the ladder onto the concrete patio below. I was wearing running shoes and, after landing and gathering myself after a couple of minutes from the shock and immediate pain, thought I might have ruptured my right Achilles tendon. After inspecting the back of my heel, though, it was apparent that the tendon was still intact and I then realized that I likely had broken at least my heel bond (Calcaneus) as I could not tolerate even the lightest touch on any part of the bottom of my injured foot. I was home alone and had to hop into the house to retrieve my cell phone, spraining my good left knee in the process.

A trip to the emergency room and an x-ray later, it was confirmed that I had suffered a Calcaneal fracture.

I was 57 years old at the time of my fall, just two weeks shy of my 58th birthday. I had gotten in pretty good shape over the course of the year, having gotten back to a regular gym routine and running with frequency, as well. I am 5'11" and weighed around 195 lbs. at the time of my injury. My ideal weight is likely around 180-185, so I was at least 10-15 lbs overweight at that time.

After finding the best qualified orthopedic specialist in the area (he is a part of the top ortho group in the area and is the only surgeon in their 12-15 member practice group that does NOTHING BUT foot and ankle surgery. Lesson #1 learned: Find a surgeon whose practice is all but focused solely on the foot!! I have complete confidence that I could not have found a better doctor to do this surgery in my area (Dallas-Fort Worth, Texas).

I had a CT scan performed a week after the injury and after some of the swelling had subsided - it showed a Comminuted Fracture (essentially shattered into three large pieces and many smaller). My surgeon could not have stressed enough how important it was to keep my foot elevated above my heart in the several days prior to the surgery and told me that, had I been much older, surgery might not have been advised due to deteriorating circulation issues in feet for patients over 60 years old. This was, in fact, his major concern throughout; namely, that adequate blood supply would allow for healing of the surgical wound required for the surgery.

I had my surgery on December 11, 2014, and stayed overnight in the hospital. My surgery involved an open lateral incision on the outside of my heel with the insertion and fixation of a titanium plate and eight screws that extend nearly all the way across the width of my reassembled heel. Because my subtalar joint was also severely damaged in the fall, my surgeon had advised me that a fusion of the Talus with the Calcaneus was likely after he visually surveyed the cartilage and he did, indeed, also proceed with this fusion procedure which resulted in about a 5" long screw being inserted from the very back of my heel near the base and extending into the Talus bone above. I was told I will lose most of my lateral flexibility in my foot but should eventually recover most of my front-to-back foot flexibility.

I had been given a nerve block after surgery and felt no discomfort at all until the nerve block wore off the next evening. When that block wears off, it does so with a vengeance! I took Oxycontin for the next couple of days, then switched to Hydrocodone for pain and Naproxen Sodium for swelling thereafter. I got off the HC as quickly as I could (3-4 days later) and still take naproxen on a regular basis to manage the lesser pain and swelling.

I will follow up in the next few days with my thoughts on my recovery progress and outlook since then - I know this post may have some overkill from a factual standpoint but I wanted to include information that I personally would have liked to have known in reading other threads.

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Any help would be greatly appreciated. Just very frustrated with the lack of function and level of pain at this point after 4 surgeries.

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My recovery has been good. I did have a couple of scares when the radiologist suggested there might be a bone infection. Fortunately, that turned out not to be the case. I suspect he was confusing healing with signs of infection. At any rate, now that it is a year later, I have pretty much no pain. I am walking every day, usually at least a mile or two each morning. Sometimes I walk up to five or seven miles in one walk. My foot is up for the task. I have started curling for the season now, and my foot is great. The last time I curled, my foot was very sore (pre-surgery). It was so nice to curl without pain! Also, with all my walking, I am in better shape than before, so I curled amazingly well. Scary.

There is some misinformation about fusions I'd like to address: Your gait will be altered with a fusion - my gait was altered by the sore foot and limited range of motion from the arthritis. Now my gait is normal, I toe off the big toe again. That means that now my hip feels better. You won't be able to run or be active - fusion is actually recommended for people who wish to remain active. At least if the foot is damaged beyond a certain point. I am more able to run now than I was pre-surgery because I have a stable foot that does not hurt. Surgery is painful - yes, I had about four days of pain that required medication. After that, as long as I had my foot elevated, I was fine. I think bunion surgery is much more painful

Fusion is certainly a drastic procedure that probably should not be considered lightly. At the same time, if it is the right procedure it is fabulous.

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Repeated Discectomy And Laminectomy And TLIF Fusion Of L5/S1

Back in 2012 after 2 years of severe sciatica that was treated with painkillers, I finally got an MRI which showed disc herniation at L5/S1, I had a microdiscectomy & the surgeon said it was a difficult procedure as the disc had calcified. I did however have some relief & a huge reduction in pain.

After about a year the pain had increased to the point my mobility was affected & I was referred back to my neuro, he carried out MRI & another micro discectomy & unfortunately this actually left me immediately in more pain.

So I had another MRI which showed again more herniated disc trapping my nerves, this was only 6 weeks after my 2nd op, my surgeon said he could do no more for me but he then referred me onto a colleague for a TLIF fusion of L5/S1.

Which was done, but again no significant improvements so after 12 weeks my neuro sent me for more MRI & CT scans, this showed halo's around my fusion screws, crowding at L5/s1 & a post op collection around the incision site, he prescribed 6 weeks antibiotic course & re-did the scans.

There was no change to the collection & he then decided he would need to operate again in case of infection.

When he operated he found no infection inside but there was 'bugs' in the fluid collection in my back.

He said the fluid was seroma & he was confused as seroma fluid never has bugs in it?

Whilst he was in my back he did yet another discectomy & laminectomy, he said he did not check the fusion itself as it meant disturbing scar tissue.

At this point he said nothing more can be done for me.

This is heartbreaking to me, I'm 39 yrs old, I have a physical job as an electrician & I don't want to be sat about or lose my job.

My pain is still extreme in my right leg & hip, my buttock still feel numb & my calf feels tight & achy.

My last op was only a week ago but after 4 surgeries on one small place, I still feel in excruciating pain & it feels like there is no light at the end of the tunnel, my back around the incision site is still swollen like it was before this surgery & I'm worried the fluid is coming back, the build up of that fluid had caused problems on my left side & had not got any smaller in the 5 months between the surgeries.

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last year on 30th November I had an accident and resulted my right leg both bones tibia and fibula are broken “ just above the 5 inches from the ankle”. I went to a hospital which is located to near my home and met doctor , after watching my x ray doctor said its a compound fracture nd asked me to have an road fitment surgery. As me and my family was not having any experience about any fracture so my parents decided to meet more doctors for consultation.

They forwarded my x ray to some more doctors and one of my relatives references 1 doctor replied in this case we don’t need to have an surgery. Me and my family was believing into that if Doctor is saying there is no need for surgery then why should go for surgery by our self.

We followed this doctor , and he treated my leg with the help of “C ARM Machine” technique and the given alignment treatment to my broken leg by pressing hard by his hands many time . he casted my leg fully with the plaster and asked me to meet after 2 months.

After 45 days of my accident i went to that hospital which is located to near my home for x ray , suddenly that doctor( who suggested me road surgery) came in front of me and i met him and shown my latest x ray. He replied i asked you to have an road fitment surgery ,now as per your x ray your bones alignment is done properly, may be your leg can fall on land wrongly and may be i cant walk in right shape like before and may be will give you pain for long time also. He asked me i still can go for surgery...he made me confused fully......i hate this

I was worried....after 2 months ..i met my doctor again and told him everything and said some other doctor is saying this....he have seen my latest x ray( 2 months xray) and replied everything is perfect , there is only little angle difference and that may not result you all these things ....its acceptable. He said that doctor is misguiding you and want to make money through surgery only. There is no need for surgery that's why i did this best treatment for u, even your bones alignment is almost about 85 % and it cant be more better than this through this manual process treatment.

I was panic thats why very next day i went back that hospital’s doctor and asked him to do road fitment surgery and shown my 2 months x ray , this time he taken his step back nd replied its 2 months passed already now don’t go for surgery it may not give that much of good results as my fibula bone is already healed. He said there are few chances only ...or may be everything will be alright also......he made me so confused....i hate this......

So i trusted again my old doctor nd decided to follow him nd next day went back to him...he cutted my old full leg plaster fully and casted new plaster till my knee only...he asked me to move my knee slowly slowly by using sitting on chair, he told me i will feel some pain because my knee is not in working mode for past 2 months...he asked me if i want to walk then i can use crutches by pushing my broken leg little up.

Now 15 more days has passed ...totally 10 weeks ..........i don’t know whats going ...i am trying to move my knee by some exercise nd it was paining in the starting .....but slowly slowly its moving better nd pains little when i start exercise for first 5 minutes only .

Still i am worried internally ....i want my leg as before ...don't want to walk in any wrong shape...i just recently got married nd having my full life ahead.....kindly tell me how much more time it will take to heal completely...and when i will be start walking normally....plz give your comments about alignments of my bones also...i m attaching my 2 month x ray pic in my profile , want to attach in the main body but not able find this option

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