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Old 12-16-2011, 07:47 PM   #1
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New Heelie - Comminuted Calcaneal Fracture

Hello Everyone,

I suffered a comminuted calcaneal fracture six days ago while on vacation in Thailand. I was flown home a couple days later and have been reviewing X-rays and CT scans with doctors since. I'm really worried about what the future holds.

I go in for surgery next Thursday to have a plate and screws put in to bring the curve back to my heel. I'm a really active person, the things that bring me happiness are being adventurous. I'm extremely concerned that I will not be able to do the things I love anymore which would be extremely depressing.

From what I've heard advances in this kind of surgery have come a long way. It sounds like I will only need a hard cast for a couple weeks after surgery, then a boot and to remain non-weight bearing for 3 months. I'm hoping with PT that I will be able to get the movement back in my heel/ankle.

Has anyone been through this recently? Are there any bright days ahead? Everything I read sounds so scarey and depressing.

 
Old 12-17-2011, 09:54 AM   #2
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Re: New Heelie - Comminuted Calcaneal Fracture

There is lots of stuff to read here on it. The injury varies alot in the extent, how its treated, and the recovery. Either way, it is a life changing event.

Keep your foot elevated, really elevated, 23 hours a day.

As far as doing what you love, you will most likely be able to, but may be limited in how often or how long.

I am doing what I want to. But I feel it at times.
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Old 12-17-2011, 09:55 AM   #3
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Re: New Heelie - Comminuted Calcaneal Fracture

Here is the crash course in being a Heelie.

Lots of stuff to read about here.

Most people are non weight bearing 12 weeks, some get partial before that. Some wear the boot and walk, I was told not to, cause it would make me uneven.

Keep your foot elevated, I mean elevated. I slept with it on 2 pillows, and two on recliner with all the way back.

Circulation will get better when you start walking. Yes, you may have a purplish look to your foot when its down. Yes, you will get weird shooting pains and sensations from time. Yes, most of the feeling will hopefully come back.

The severity and recovery time really varies. But a year is ball park, with gains until 18 months, with people saying it still gets better for a few years.

You may want to wear a compression sock when you start to walk. Sorta knee high stocking, that is very tight and helps with swelling. I wore one until about 10 months, and was told some do forever. I still get a bit of swelling around 2 years. Wear a sock over the compression sock, for comfort.

I wear light wool hiking socks year round. Get good cushiony socks.

Physical therapy is very important, be strict and do it. I started with range of motion about 6 weeks.

Your calf is going to shrink a lot, and your thigh. You can help your thigh a little by doing leg exercises, with out weight.

Calve raises will help the calf, when the time comes. You will have to do them with both feet. As time goes on put more weight on the bad foot. I still can’t do a one footed, and probably never will, but many can.


This is a life changing event, that’s just the way it is. IMO you got to be tough and push, you will no when it really hurts and time to stop.

Many people get custom made orthotics a few months after then start walking. Wear them for short periods at first, increasing time. You will need a deeper shoe to fit it. New Balance plus others make them. You will probably never wear cheap foot wear again.

Some people say don’t spend much on shoes the first year, but I say you got to wear something. You will probably need a wide shoe. Some wear two sizes, some just tighten the other, which is what I do.

When I went back to work I started with 6” lace up boots, cause my ankle was weak, I eventually moved up to 8” and find 8 a lot better. I wears 8” lace up boots for pretty much everything. I had to switch to tennis shoes to drive. Eventually I figured out to untie the boot for driving. This seemed to work. Now I can drive hundreds of miles with my work boot on.
I think it was good for two reasons to wear the tennis for most of the first year. My foot was weak, and it hurt more with boots. Plus I think the shoe allowed greater range of motion.

Fusing is a common treatment for this, they screw your foot together. Which limits movement, but you may have lost it anyways. I didn’t have surgery, cause I was in to bad of shape. I may someday, if the arthritis gets to bad.
Yes, you will most likely get arthritis.

I wonder if they operate to much, or if I would be better off. If I was going to have it, I think I would have preferred to do it right away, and only recover once. But if I have it now, I can pick when to do it, and get things in order.

As for pain, for me its not so much the heel but the outside ankle, because I also shattered my subtalar joint, which is not uncommon. I also have problems with my Achilles. Not a lot of pain until I started walking. But it gets better, every week and month. Things were decent by month 11.

I started walking at 12 weeks, still used wheel chair a bit for couple weeks. Wheel chairs do help. Some people get knee walkers or scooters. Then I moved to walker some of the day, then walker and cane, and then just cane. I was to cane in 3-4 weeks, but still using waked when I went places for awhile.

By 5-6 months the walker was gone. In the beginning you will notice improvement almost weekly, if you try. Then it slows up a bit. After year it got slow for me.

It is illegal in many states to drive with just your left foot, so keep that in mind. Many people start driving with 3-4 months.

Many heelies have problem on uneven surfaces, due to less range of motion. This may be worse when it fused.

As for pain, I don’t have a lot on normal days around the house. But if I do a lot I feel it. Everything has a price.

I gave in around month 18 and started taking tramadol/ultrum few times a week. Again this really depends on use. I think it gave my life back. Not sure if I would do it to soon in the recovery, you need the feedback from your foot, and you need to know what you are capable of.

As I said, normally walking around, doesn’t bother it much. Long days on concrete, gravel, and ladders do. I resisted the pain meds, until a heelie told me you put glasses on to read, so why not take meds when it hurts. I take them more for work then anything.

I believe in rationing the pain. Just because you can do it, doesn’t mean you have to. I sit down whenever I can. Conserve your pain currency. Find mechanical ways to do things, lifts and hoists. I carry a folding chair in my truck.

Use rubber mats in the garage for standing on. I have a rubber mat at the kitchen sink and one in the shower. For the kitchen I took a foam mat and put a rug over it.

I put rugs in my bedroom, to make a path to the bathroom. This was more an issue in the beginning. But is still nice.

Your probably going to go through a lot of footwear finding the right pair, and probably different footwear for different functions. I am constantly on the quest for the ultimate boot.

I walk barefoot around the house, but it needs to be limited. I think it will aggravate plantar fasciitis. I roll my foot on a golf ball or a frozen water bottle when it bothers me.

Around the house I wear walking sandals with lots of cushion, but recently moved to a pair of slips on that have a lot of arch support, that I really like. I have also wore old tennis shoes, that I leave loose enough to slip on and off.

Your joints are full of fluid, so when the barometric pressure changes, you may feel it. More so, when the pressure drops before a storm. Usually feels better when the storm comes through.
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Old 12-18-2011, 03:15 PM   #4
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Re: New Heelie - Comminuted Calcaneal Fracture

Hi New Heelie, I had my surgey November 8th-five weeks ago. I broke my heel into four pieces after an extension ladder slipped sending me carshing ten feet to a wooden deck. Like you, my life revolved around being active and traveling.

Just a few bits of feedback on my surgery. I have never had a serious injury before. The pain after the surgery was far and away the worst of my life. The nerve block they gave me was not placed properly so it did nothing to relieve the pain. Do not be shy about asking for Dilaudid. I had it in an IV AND in a pain pump and the pain was still a 8-9 on a scale of 10. They planned on discharging me the day after surgery. Yea, fat chance. There was no way I was giving up the IV pain meds and pain pump for some Hydrocodone pills to take home with me. They did the nerve block over and got it right the second time. I went home on day three with Percocet after insisting Hydrocodone will not get the job done.
The pain medication will make you constipated so get some Exlax. It will also kill your appetite. Be prepared to be incapacitated. You are going to need a caregiver for at least a week. If you can get one for longer, do it! Get some reading material together, get some DVDs rented and fire up the DVR because you are not going to feel like doing anything.

The good news is after two weeks I was able to cut way back on the pain meds which resulted in more regularity and somewhat of a return of my appetite.

I am fighting depression which was compounded by nine months of unemployment after being laid off. If friends offer to come over and visit accept their offer. Just having someone to talk to and get your mind off your foot helps a lot. On the flipside I am coping with next to zero help from near by family members. They will call sometimes and encourage me to call them if I need help but, I am the type that does not want to inconenience people. (Note to family members of someone going through this-do not just offer to help. Tell the injured you are coming over tomorrow and ask what errands you can run for them and what can you bring over!)

Hope this helps. Let me know what questions you have. Good luck!!

 
Old 12-18-2011, 07:10 PM   #5
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Re: New Heelie - Comminuted Calcaneal Fracture

The doctor said I would stay in the hospital overnight after the surgery, but will most likely be allowed to go home after. I have 3 meds prescribed, 2 pain killers and a relaxer. Hope this will be enough. How long does the pain last?

I made arrangements to fly a family member in to stay with me while I get through this. I was hoping by a week or two out of surgery that the ain would be manageable and I could comfortably relax around the house and read / watch tv like I am now using the 1 pain killer.

My hope is to start working from home within a month from now. I do design on the computer. As long as the pain in under control and I can keep my leg raised and not move around to much on it do you think this will be possible? I'm not too concerned about being a homebody, I am concerned that I won't be able to do my work from home and keep myself
busy so I don't get depressed.

 
Old 12-19-2011, 05:56 AM   #6
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Re: New Heelie - Comminuted Calcaneal Fracture

As far as depression goes, what choice do you have in the matter? You need to have the right attitude, to get through this. Though even if you have a bad attitude you will get through this, cause as I said, you don't have a choice.

IMO to many people worry about depression. I don't know if they really are that way, or they just read so much about people talking about depression.
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Old 12-19-2011, 07:55 AM   #7
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Re: New Heelie - Comminuted Calcaneal Fracture

If you work at home, you are way ahead of most of us. While we worry about our injury, we also have to worry about returning to work or even if we will have a job afterwards.
If we have a job where we are on our feet all day, we may not even be able to do it.

The ramifications of breaking a heel depends on what other injuries you have with it. Usually the force it takes to break a heel also injures other joints, especially the ST joint and this is usually the "biggie".

What's the outlook your doctor gave you?

 
Old 12-19-2011, 11:55 AM   #8
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Re: New Heelie - Comminuted Calcaneal Fracture

The doctor said he was going to need to put a plate and screws in, but seemed confident that I will get through this. One side has a big crack the other has smaller break pieces. I'm determined to do everything I can to heal properly.

 
Old 12-19-2011, 03:26 PM   #9
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Re: New Heelie - Comminuted Calcaneal Fracture

Keep it elevated and stay off it, until you are given the OK. Do the physcial therapy at home. I started ROM around 6 weeks, had to ask my doc about it.
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Old 12-19-2011, 08:40 PM   #10
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Re: New Heelie - Comminuted Calcaneal Fracture

Hi,
I fell 14 ft off of an extension ladder on 9 November 2011. I have a severe comminuted fracture of the calcaneus. I underwent surgery on 17 Nov. It was an extremely complicated 6 hour surgery and the future forecast was rather gloomy. The doc (who is extremely knowledgable and specialized in ORIF calcaneus-cuboid surgery) told my husband while I was in recovery that if it had been any worse, I would have lost my foot. I have a plate, screws, pins, and some artificial bone.
First, let me say that I have been covered with much prayer. I think that has been very important in my recovery. Second, I have tried to stay most positive. It has been hard and sometimes, when I am alone, I cry a little bit and have a little pitty party and then I am I get back in step to give my best to recovery.
I am 53 years old but don't let that fool you. I am an athlete. swim, lift weights, kayak, yoga, martial arts, and I run. Running is my favorite thing. The doc said that I will never run again. However, at the beginning I was told that I would not get a boot until month three. I received my boot last Friday (which was week 5). I am almost two months ahead of schedule. My Doc said there would be no weight until week 12 but at my last appointment she told me that my x-rays looked so good that she would start having me put weight on it at week 8.
I have followed doctors orders to the tee. I have not pushed myself. She made me lay in the bed for like two weeks. After that, I was still mostly in the bed....but did move around some. I have a wheel chair, a walker, and crutches. I may or may not get the knee walker as I turn my wheel chair around, put my knee it and move around pretty good that way.
My husband has made sure that I eat properly. Calories, calcium, and protein are very important in the healing process.
My incision has healed beautifully. I am doing okay with the pain. I do my ROM exercises. I follow all orders.
I guess what I am saying is that I am learning as I go. Yes, it is hard for someone who is use to being very active. Am I going to be doing all the stuff I love to do ever again? I hope so but I don't know. What I do know is that I am doing everything exactly like my doc says and it is all going well so far. Keep us updated and I will post my progress as well.

 
Old 12-20-2011, 08:04 PM   #11
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Re: New Heelie - Comminuted Calcaneal Fracture

The pain lasted for two weeks in my case. I started with meds every four hours and gradually used less until I could do without after two weeks.
I hope your experience is shorter. Being able to work from home will be good. It will keep your mind occupied and less stress about being away from the work place.

Showering becomes a whole new experience. I got a small stool from the drug store to sit on in the shower. My shower has a hand held attachment. This really comes in handy. You can direct the spray so your cast is not getting drenched. As far as keeping your cast dry, trash baqs are not convenient. I got a cast cover from amazon- (Duro-Med Adult Short Leg (23) Protector). It works great.

Cooking in the kitchen on crutches is no fun. I roll around on an office chair in the kitchen. It is much easier to put together a meal seated.

My bedroom is upstairs but, I have a guest room downstairs so I moved into it. I am avoiding stairs whenever possible.

When is your surgery? We're pullin for you! Keep us posted.

 
Old 12-20-2011, 08:10 PM   #12
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Re: New Heelie - Comminuted Calcaneal Fracture

[QUOTE=guinivere;4897203]Hi,
I fell 14 ft off of an extension ladder on 9 November 2011. I have a severe comminuted fracture of the calcaneus. I underwent surgery on 17 Nov. It was an extremely complicated 6 hour surgery and the future forecast was rather gloomy. The doc (who is extremely knowledgable and specialized in ORIF calcaneus-cuboid surgery) told my husband while I was in recovery that if it had been any worse, I would have lost my foot. I have a plate, screws, pins, and some artificial bone.
First, let me say that I have been covered with much prayer. I think that has been very important in my recovery. Second, I have tried to stay most positive. It has been hard and sometimes, when I am alone, I cry a little bit and have a little pitty party and then I am I get back in step to give my best to recovery.
I am 53 years old but don't let that fool you. I am an athlete. swim, lift weights, kayak, yoga, martial arts, and I run. Running is my favorite thing. The doc said that I will never run again. However, at the beginning I was told that I would not get a boot until month three. I received my boot last Friday (which was week 5). I am almost two months ahead of schedule. My Doc said there would be no weight until week 12 but at my last appointment she told me that my x-rays looked so good that she would start having me put weight on it at week 8.
I have followed doctors orders to the tee. I have not pushed myself. She made me lay in the bed for like two weeks. After that, I was still mostly in the bed....but did move around some. I have a wheel chair, a walker, and crutches. I may or may not get the knee walker as I turn my wheel chair around, put my knee it and move around pretty good that way.
My husband has made sure that I eat properly. Calories, calcium, and protein are very important in the healing process.
My incision has healed beautifully. I am doing okay with the pain. I do my ROM exercises. I follow all orders.
I guess what I am saying is that I am learning as I go. Yes, it is hard for someone who is use to being very active. Am I going to be doing all the stuff I love to do ever again? I hope so but I don't know. What I do know is that I am doing everything exactly like my doc says and it is all going well so far. Keep us updated and I will post my progress as well.[/QUOTE]

I wonder what % of heel fractures are a result of extension ladders? I will never get on one again. We need to tell everyone we know to stay off these things! Your injury sounds horrible. The pace of your recovery is inspiring!

 
Old 12-21-2011, 04:44 AM   #13
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Re: New Heelie - Comminuted Calcaneal Fracture

Most heel injuries are falling off ladders and roofs, the rest are auto accidents. There are a few rock climbers too.

I used a walker, its alot more stable then crutches, just can't do stairs with it. Also a wheel chair around the house makes life easier. Its also good for when you got to go places.
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The good thing is, no one asks me, to help them move anymore.

 
Old 01-26-2012, 07:04 PM   #14
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Re: New Heelie - Comminuted Calcaneal Fracture

Somehow I got an infection in my incision and have to go in this weekend and have it opened up and flushed with antibiotic fluids.

I will have some sort of vacuum thing attached to an opening in my incision that flushes the area out for a couple weeks after I get out of the hospital. I'll also have to be on intravenous antibiotics for 6 weeks to also help combat the infection.

I'm a bit worried about having a tube sticking out of my arm that I hook up to a bag of antibiotics twice a day for six weeks on top of some vacuum thing sucking crap out of my incision area. If I don't do this the infection could spread and ruin the bone as well as the plate and screws that we're out in, so I understand why it's being done.

Has anyone had to go through this?

 
Old 01-27-2012, 05:45 AM   #15
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Re: New Heelie - Comminuted Calcaneal Fracture

I have not gone through this with my calcaneus fracture but did go through it with my husband when he had a ruptured aortic anuerysm. It is something that you are just going too have to go through. Try to look at it as another hurdle and be glad that they can treat it and you will not end up with gangrene. Although it does take time, it is really not that bad. It just sounds bad. God Bless!

 
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