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Old 10-03-2010, 07:17 PM   #1
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Severely communited calcaneus fracture

Hello everyone,

Forgive me for starting a new thread for these fractures. I fell 15 ft from a ladder 10/08/15 and suffered what the ER doc called an "explosion fracture" of the right calcaneus. I was seen in the orthopedic clinic 3 days later and told that they wouldn't do surgery. I saw what was to be my regular ortho surgeon 3 weeks later who said he didn't have to do surgery. At the time he also said that my heel would be permanently 1/2 inch shorter than my other heel and that arthritis is a certainty. I was then told to come back in 5 weeks which will be this week.

Doing my own research, it would seem that I have a Type 1V or Type V Sanders fracture and that the reason for not doing surgery is because of a very high failure rate for this type of fracture. Basically it is being left to heal on it's own and whatever happens happens. This is coming from a well recognized trauma surgeon in a level 1 trauma centre.

I am now going on my 8th week NWB and feeling pretty good. I have gone back to work on modified duties using a wheelchair to allow me to keep my foot elevated somewhat. I am also going absolutely crazy being non mobile and being so dependant on other people!!!

I am terrified of not having a reasonable facsimilie of my old life back and am wondering if anyone else has had similar experiences and what the outcome was. Is there anything I can do to assist recovery?

 
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Old 10-04-2010, 04:38 PM   #2
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Re: Severely communited calcaneus fracture

[QUOTE=Firelady1;4338674]Hello everyone,

Forgive me for starting a new thread for these fractures. I fell 15 ft from a ladder 10/08/15 and suffered what the ER doc called an "explosion fracture" of the right calcaneus. I was seen in the orthopedic clinic 3 days later and told that they wouldn't do surgery. I saw what was to be my regular ortho surgeon 3 weeks later who said he didn't have to do surgery. At the time he also said that my heel would be permanently 1/2 inch shorter than my other heel and that arthritis is a certainty. I was then told to come back in 5 weeks which will be this week.

Dear firelady1: Surgery decision also depends on age, smoking history & heel displacement. Ask if you may need a primary subtalar fusion if you develop arthritis. Recommend a knee walker for mobility. You may have a quicker recovery without surgery but you will still go thru nonWBing & rehab.
Total recovery can be 18mos-2yrs.Hang in there!
Desross4

 
Old 10-04-2010, 05:22 PM   #3
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Re: Severely communited calcaneus fracture

Thanks for responding desross

I am 45, non smoker, not too sure about displacement as no one has really said much to me. I have an appointment on Thurs and intend to ask lots of questions now that I have a better idea what this fracture is all about.

Another question.....my pain experience has been very strange. First two weeks were quite painful, then go for a couple weeks with no discomfort, then couple weeks of very painful, then no pain. Pain seems to be concentrated right at the bottom back of the heel. Very sharp pain, almost like something inside is sharpe and cutting internally. Is this normal for most "heelies"?

 
Old 10-05-2010, 03:47 PM   #4
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Re: Severely communited calcaneus fracture

Hi Firelady, I shattered my right calcaneus in Dec 09. I am a 53 year old male and did not have surgery because the fracture was non displaced but the bone was in many pieces. I had pain for the first 4 or 5 days then on and off for quite a few months. I had what felt like random electric shocks up untill about a month ago. You will get alot of different sensations as the nerves regenerate. I was NWB for about 10weeks, PWB for a few weeks then FWB around 12 or 13 weeks. Did hydro therapy as soon as Doc let me go PWB, the water pressure actually decreased swelling. I also purchased a compression sock, it was very usefull in reducing the swelling. I walk normally and only limp a bit when I get really tired. I am doing everything now that I did before the injury only a bit slower. My calf muscle is about 2/3 the size of my non injured leg and is still weak but is getting stronger. This injury is slow to heal but it will get better so hang in there.

 
Old 10-05-2010, 06:35 PM   #5
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Re: Severely communited calcaneus fracture

Oh thank goodness Toyman, to know that it is somewhat normal. I will have a great week or two and then all of a sudden I get this pins and needles from heel to knee and up to my toes and bottom of my heel feels like day 1 all over again.. It goes away again and then returns another time. I think part of it may also be the way I lay in the air cast and pressure points.

Did you have pain at the bottom of your heel when you started to bear weight? Mine still feels so tender I can't even think about putting weight on it.

 
Old 10-05-2010, 09:46 PM   #6
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Re: Severely communited calcaneus fracture

Dear firelady1:

Your age & nonsmoking status are in your favor. I would suspect your heel was not displaced. I lost >1/2 in in heel height on my right heel. Got custom orthotics & had the right one built up more.

Re: pain - haven't had much since the 1st few weeks after my auto accident. Occasionally it seems to bother me more on rainy days or if I overdo the walking the day before. Pins & needle feeling is isolated to my foot. You may notice it more when you breathe in deeply or get an adrenaline rush. I think it's like a "fight or flight" thing. Kinda strange! I have noticed more pain around heel when walking (since my revision surgery). Thick socks and compression sleeve seem to help that.
Desross4

 
Old 10-06-2010, 04:16 PM   #7
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Re: Severely communited calcaneus fracture

Hi firelady, nope no pain from the heel when I started weight bearing. Got lots of "Shocks" and pins and needles in the foot. My biggest problem was muscle weakness, and of course the anticipation of that first step. Everyone is different, press on with your recovery.

 
Old 10-07-2010, 04:02 PM   #8
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Re: Severely communited calcaneus fracture

Did your doc say anything about your STJ? The biggest problem I am having is with discomfort associated with the STJ. I flattened mine so side to side movement of my foot is limited and I get some burning when I push things.

 
Old 10-07-2010, 06:51 PM   #9
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Re: Severely communited calcaneus fracture

Saw him today and he was amazed at how well I have healed!!! There are still a few very small fragments that will need a slight bit more time but the larger fractures have healed beautifully. He has cleared me to start weightbearing and physio with the hope of weaning off the walking boot within 3 weeks or so I cannot believe how happy I am!!!

I did ask about the STJ, and whether I would require a fusion. He said that was a possibility, but we'd see how things went. He did say the joint was involved in the fracture, but didn't seem too concerned about it. If I do require a fusion, it will have to wait for a bit as I"m not interested in being bedridden for months again any time soon

Talk about the greatest pleasures in life.....bathing my foot and shaving my leg for the first time in 2 months was like the best ever possible indulgence lol.

 
Old 10-08-2010, 04:48 AM   #10
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Re: Severely communited calcaneus fracture

I wrecked my STJ. One ortho said, there are people walking around pretyy bad xrays. I am not in hurry to get it done, due to recovery. But I do wonder if it will be one of those things, I wish I would have done it long time ago, if i do it.

I got 10 more years under work comp. I figure, by then I will know. Who knows what medical advancements will occur by then.

Another doc mentioned shaving the bone down to take pressure of ligaments.

Last edited by Zerk; 10-08-2010 at 04:54 AM.

 
Old 10-08-2010, 06:09 AM   #11
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Re: Severely communited calcaneus fracture

Quote:
Originally Posted by Zerk View Post
I got 10 more years under work comp. I figure, by then I will know. Who knows what medical advancements will occur by then.
Hi Zerk,

I'm curious about this statement - is there a statute of limitations or something on the health care that work comp is paying for? Have you already settled with them or are you still actively receiving care from your dr?

What if you wanted to get your stj fused 15 years from now. I'm not sure how old you are, but you may decide to have it done or you may decide 15 years from now that you want to do it.

Step
Thanks!
Step

Last edited by stepbystep89; 10-08-2010 at 06:11 AM.

 
Old 10-09-2010, 08:25 AM   #12
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Re: Severely communited calcaneus fracture

Work comp will pay for meds the rest of my life. But in WI there is a 12 year limitation, which I think applies to surgeries. When I was doing my end of healing evaluation the doctor said I may need ankle surgery someday and some other things. I don't know if because those injuries were identified as part of the accident I can get them repaired later.

I suspect in 10 years, I will know if I need it fused or not.

WI also places a values on loss of body parts, but its not much. If I would have lost the entire foot I would have only got $75. Though my injury was not the companies fault, it was third party, but happened while I was doing my job.

To my knowledge there is no settling with work comp. I have not signed anything.

 
Old 01-30-2012, 04:54 PM   #13
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Re: Severely communited calcaneus fracture

Quote:
Originally Posted by Toyman57 View Post
Hi Firelady, I shattered my right calcaneus in Dec 09. I am a 53 year old male and did not have surgery because the fracture was non displaced but the bone was in many pieces. I had pain for the first 4 or 5 days then on and off for quite a few months. I had what felt like random electric shocks up untill about a month ago. You will get alot of different sensations as the nerves regenerate. I was NWB for about 10weeks, PWB for a few weeks then FWB around 12 or 13 weeks. Did hydro therapy as soon as Doc let me go PWB, the water pressure actually decreased swelling. I also purchased a compression sock, it was very usefull in reducing the swelling. I walk normally and only limp a bit when I get really tired. I am doing everything now that I did before the injury only a bit slower. My calf muscle is about 2/3 the size of my non injured leg and is still weak but is getting stronger. This injury is slow to heal but it will get better so hang in there.
Hi Toyman57, your account of your healing was very helpful, but i would like you to tell me it in more details(my fracture is just 3wks old) how things really went example..in 6wks the cast was removed then etc etc...until your happy ending!...thank you

 
Old 01-31-2012, 05:02 AM   #14
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Re: Severely communited calcaneus fracture

As nice as it would to think you can follow step by step, the real world just doesn't work that way.

Most you can do is generalize. Its a body not an engine. Figure weight bearing around 12 weeks, some people partial before that. The following 8 weeks for me were incredible in the progress. Seemed almost week to week I could do some little thing new.

Guess you will be walking with a cane 4-6 weeks, earlier but you probably shouldn't. I was about heeled about around a year, with some slight progress after that.

My ROM was known around 6 months, maybe sooner. It got easier, but didn't really increase.

Your going to have good days and bad days, which may be the case the rest of your life. My bad days aren't as bad anymore, but certain, days, could be better.



When it really comes down to it, you got no choice, but to wait it out. Once you get the clearance to bear weight, you can't let pain or fear hold you back.

I was excited for the 12th week. Some people are scared. First time putting my foot was anti climatic, just put it down and didn't feel anything. But your foot has not been used in a long time, and will be very sensitive.

Comfortable shoes and socks, the rest of your life, will make it easier on you.
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The good thing is, no one asks me to help them move anymore.

 
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