Calcaneous fractures. - Foot Problems Message Board

MadMax79 · 02-12-2004, 06:48 PM

I fractured my left calcaneous, and shattered my right one ( 20 frags). I now have 7 screws and a metal plate in the right calcaneous. The movement in my right foot is very limited, I cannot walk on uneven ground, I get cramps in my right foot and the pain keeps me up at night. The injury happened 4 months ago. I would like to hear from those that have this type of injury, how long its been and the outcome. Thanx
MM79

heel fracture · 02-14-2004, 10:41 AM

Hi!
I had a severe comminuted fx of right calcaneous Nov 3rd in Mexico jet-skiing. Only something I have done for 12 years and was training to race this year to qualify for the World Championships. Basically split my heel in half top and bottom half from the front to the ankle joint and second fx splitting the bottom half front to back into right and left sided pieces. Have two screws going from right and left sides through the top piece into each of the two bottom pieces. Also had a small fracture on the top of my right tibia and a lot of knee pain. Knee is still stiff at times. I had a lot of cramping and spasm in the foot the first two and a half months and at night I would have to stretch out the leg to get rid of the spasms that went up to mid upper leg. Was casted for 10 weeks then started PT. I normally go to the gym regularly and am very active and in very good shape. Could not believe how the whole leg shrank into nothing, even the other leg weakened. Had some RDS symptoms, color changes in the foot, severe nerve pain, sweating of some areas of the foot. MD put me on Neurontin immediately to prevent full blown RSD and it has helped tremendously with the nerve pain. I also take Motrin 800mg three times a day. I've had 11 scessions of PT so far and it is going well. I can walk a little with no help and mainly use a cane. I'm realling pushing it with the PT, I'm determined to walk normally again and wear my little summer sandals. At first I was afraid I was doing to much because of the pain but actually what the pain was was from breaking up all the scar tissue and in doing that the mobility is getting much better. Front to back mobility is very good side to side is still limited but gradually and continually improving. Also for the nerve pain stimulating it by massage, going in the hot tub and letting the jets massage it has helped a lot. For nerve pain the best thing is to desensitize it by stimulating it-hurts at first but the more it is stimulated the better it gets. Also find using the nerve stimulator at the end of each PT scession helps a lot with the pain. I got silicone gel heel cushions and wear sneakers that are like clogs with no back on them. With your injury and hardware if you can walk at all at 4 months post-op I think you are doing well. I was lucky enough to get a top surgeon on the east coast and he told me that the only thing he could tell me was that a year after surgery I would be the best I was ever going to be and he did not know what that may be. At this point he said I should do well what ever that means! He knows I'm agressive and determined to be normal so at this point every time I see him he says "you need to know that this is a life changing and maybe a career changing injury" My response is "yea but will I be able to race my jet ski this season I was planning on qualifying for World championships this year" It makes him crazy but keeps my hopes up.
Are you getting Physical Therapy? What are they having you do? What type of shoe are you wearing? Are you on any medication? How do you have your bed arranged for sleeping?

MadMax79 · 02-14-2004, 06:23 PM

Hello,
Thanx for the replies. I made a mistake my injury was 3 months ago. I fell from my roof on 14 Nov 03, it was a 15 foot fall. The ground was frozen so it was like landing on concrete. I had to crawl/shuffle approx. 60 feet to get to the phone to call for help. I spent 6 hours in the ER. They x-rayed and CT scanned my feet. They put both feet in the Jones splint and requested that I stay the night. I convinced them to let me go home and they did. They shot me full of morphine and sent me on my way. The fracture on my left heel was located on the back/inside of the calcaneous. The right one was comminuted, the top part of the calcaneous imploded into the lower part of the calcaneous. My r/heel was twice its width. The portion of the calcaneous that was located in the ankle joint was in 3 pieces the lower part was in 5 large pieces and 12 smaller ones.
I followed up with an Ortho Dr. on 17 Nov. They told me the r/foot would need surgery (OFIR), and to come back in a week. They wanted the swelling to decrease. On 24 Nov the left foot was casted. On 26 Nov I had the OFIR. On 9 Dec my stiches were removed and my r/foot was casted. On 30 Dec both casts were removed. I was given a "boot" for the right foot. My Dr. wanted me to be able to start moving my foot asap, to gain mobility. He wanted me to take the boot off when I was sitting around, when I was going anywhere I was to put the boot on, I was also told to wear it when I went to sleep. To protect the bone.
I started PT on 12 Jan. and I go 2-3 times a week. My PT routine consists of 10 min stationary bike, leg presses, leg curls, leg extensions, lunges, calf extensions, a few balancing exercises, and side stepping ,walking backwards and forwards with weight, and small hoping in the shape of a square and ultra sound.
I have been walking w/out assistance since 20 Jan. I do have a limp that is very bad at times, my right foot is slightly pigeon toed when I walk. The movement in my right foot has not increased in the last 2 weeks. The front to back rotation is severly limited, I cannot point my right foot like I can my left. and the side to side tilting of my foot is darn near gone especially when weight is applied.
As for meds I take Ibu's during the day and at night I sometimes take Percocet, they are left overs from surgery. This Monday I am going to call the Dr. I ask for a pain med that is stronger than IBu's for day use and something for night.
My shoes are Nikes and GBX. I cannot wear boots, they are extremely painful on the soft tissue of the r/foot.
Last night I noticed a bruise on my left heel in the area where the achilles tendon attaches to the calcaneous. My right is still swollen and according to my Dr. It will be for a year. My Dr. says that worst case would be a subtar fusion, that is if I develop arthritis or if the cartilage deteriorates. The waiting game. I did find a pic of some surgery that was similar to mine hardware etc... I will try and find it again and post it here.
I pray that you both have a great recovery. I tell you it sure is nice to be able to share experiances w/others that are going thru the same...
c u later .
God Bless

heel fracture · 02-28-2004, 02:19 PM

Hi Max
I have to say with all you had happen it sounds like you are doing quite well. Your injury was after mine and I'm still trying to get into a show that is not a clog. I had to have some heel tissue removed it became necrotic from lack of circulation and every shoe seems to be on that spot. Keep up your hard work in PT. Remember no calcaneous fx is going to be at their best for a year, long as that sounds. Keep smiling and working the way you are and you will get better than you are now. Have you returned to work?
Take care

tchair · 03-02-2004, 06:38 AM

Hi all,
To get the counting out of the way, 7 foot fall onto concrete, one plate, eight screws and a bit of hip bone to rebuild the arch. That was eight years ago. Then, there seemed to be no one else or information any where. Now there's a run on these things! And I guess for some vacations we'll have to add "don't jet-ski" to: don't drink the water.
Circulation is the big key. I had my foot in a sling over the bed for months. It was a home made (PVC pipe and clothes line) version of the hospital ones. After that I put my ankle over a pillow wrapped around piece of said pipe. The second part of that is that in using your leg muscles as much as possible you not only have them in shape but that using muscles is actually a part of circulation.
I only had 13 frags. On the catscan you could see clear through the middle. The swelling takes a year to go down completely. Getting the most range of motion even longer. Improvements can be gradual. When I got impatient I had a family member who would remind me of what I couldn't do the previous week or month. I think that a year after surgery you'll know where you have some limitations, but that won't be the end of improvement.
I spent my first walking year in oversized sneakers, couldn't have any pressure on foot especially pressing up on arch. After trying countless shoes over the years I now wear stiff sided leather shoes with the most flexible soles I can find. Maybe with a whole lot of trial and error something will turn up for hf.
I had also damaged a nerve on the side of my foot - You'd know if you had it would be unrelenting and go straight to your brain. For that I tried all sorts of blocks and medications, then a Peripheral Nerve Stimulator implant. It goes to the single nerve that's a problem and has no effect on the rest of my foot or ankle. Here's the good news. I had been working in a warehouse and the first thing most every doc said was that I'd never go back to that. When I went back to work it was to a desk job. I quit that for something on my feet. and when I thought I was ready I got a another warehouse job. Although I can't walk without my orthodic, but with it I can run. I've worked on my roof. (Maybe you should delay that a while MM). It's pretty well accepted that a fractured calcaneous is the worst, 90% being from falls, beat out only by the others from car accidents.
For nerve pain Ultram worked, Benedryl for sleeping, and Clonezapam/Klonopin for both. I had no luck with neuruntin. For any medication different people have different results. And docs are the experts so don't take posts even mine for gospel.