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  • Comminuted Navicular with some serious consequences

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    Old 01-11-2007, 11:22 PM   #1
    ldbeer's Avatar
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    Comminuted Navicular with some serious consequences

    When I was 21 I fell from a ladder at work from a height of about 4-6 feet. Due to some interesting properties of physics, I managed to get a comminuted fracture to the Navicular, as well as some much less serious fractures to the metatarsals.

    Well, because I was so young, My rather skilled surgeon decided not to fuse the joints surrounding the Navicular, but repair it. He was able to do an excellent job, and I am left with a full range of motion.

    However, I am also left with some rather serious post traumatic arthritis.
    I've been living with this for two years, and the only conclusion I've been able to come to is that my present situation isn't something I want to accept.

    Simply put, my level of physical activity and fitness level have plummeted, and I struggle with everything I do. Even the relative sedentary live of a student can often prove to be too much. I don't want to make this post too long, but pain levels are high and come on quickly.

    My options presented to me thus far are
    1) live with it
    2) midfoot fusion
    3) amputation

    I have tried to live with it and simply can't. As part of my recovery I began some martial arts training. It wasn't roughousing kung fu or anything, think Tai Chee, and it was extremely fulfilling. I had to quit, however, when I went back to school, as I couldnt handle that much time on my feet.
    I occasionaly get a few steps without pain, but thats it, and while braces, a tens machine, and athletic tape do help, I still pay a heavy price for any level of physical activity.

    I've done a little biking since the injury, but an hour of light road biking can mean a lot of extra pain in the following days. And skiing, which I have done religiously since I was 3 is so far out of the question I want to cry.

    Now, one of my doctors put it to me this way:
    "if you want full range of motion, leave it. If you like your foot, fuse it. If you want functionality, amputate"

    Now, I really really want functionality. But I am also rather attached to my feet, I have really nimble toes, and can pick up things on the floor and hand them off to my hands. In short, I like my feet.

    I would really really like to hear from people who have gone through midfoot fusions. What kind of functionality are you left with?

    Now, I will HAVE to get it fused. I can't leave it like it is, I've gained 25 pounds, and lost probably 15 pounds of muscle. And as much as I'd like to immediately get it amputated, thats a life long choice. So despite the long recovery of a fusion, I have to try it out.

    Anyone else have a similar injury/symptoms? I am open to expand my options beyond the three above.

    Finally, what about amputees. I would have done it already, except for the heavy psychological burden involved.

    thanks for your responses

    Lorin Beer

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    Old 01-12-2007, 07:37 AM   #2
    snwtygr's Avatar
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    Re: Comminuted Navicular with some serious consequences

    Hi - so sorry to hear about your troubles ! Second opinion is very warranted. You can still stick with you doctor if you feel he has the experience but seeing someone else if not for anything but peace of mind is very important. Mid foot fusion - would that be triple arthrodesis: fusion of calcaneus/talus, cuboid/calcaneus, navicular/calcaneus. How is your ankle joint ? Arthritis there ? Everyone is different in their reasons for needing a fusion and respond differently to fusions depending on what their baseline is BUT I had bilateral triple arthrodesis and I am progressing to a point where I am able to walk extended distances, never ran before due to my original deformity but plan to run a 5K by summer. I water ski, roller blade and if it ever snows this year I may try snow skiing. I work in a busy ICU as an RN where I am on my feet most of the day. My range of motion is within normal range (better than before surgery). Before surgery I had NO degrees of dorsiflexion. My side to side motion is STILL intact. Many people report losing theirs and I asked my doctor about this and he said he does the most triples in our area and it's due to his experience and patient selection. I can walk on uneven surfaces and have excellent balance. At times my feet feel stiff and sore at the end of the day but many "normal" people have that too. DO NOT be afraid to find an expert for a second opinion and ask questions. Your life and quality of life is too important to not give yourself that chance. Experience is the key - find someone that does at least 8/year - trust me that's alot and you will be surprised that there aren't many. Here in my large midwest city there are possibly 3 or maybe 4 that do that many. Most surgeons send patients to those guys for triples. If you find doctor websites and they say they do triples don't be afraid to email or call them and ask some questions such as how many they have done before you make an appointment and possibly waste your time/money. Anyway, please try investigating fusion before you jump to amputation. It scares me that your doctor even gave you that option. If he's not comfortable doing a fusion there are others that would love to get their hands on it and do an awesome job. My case is one example of how things can really go right but you MUST do your homework. Please let me know if I can help you any more or if you have any more questions. Good Luck

    Old 09-10-2008, 07:51 PM   #3
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    Re: Comminuted Navicular with some serious consequences


    How's things with the foot? What did you decide to do.
    My navicular bone must of had a stress fracture or something similiar when I was 17. That was 32 years ago. The break wasn't officially recognized for 9 years when a doctor thought I had calcium deposits. I had 3 surgeries to clean the joints and keep me walking. This was a pretty good alternative seeing how I was unsure about having my foot fused. My last and fourth surgery fused the mid section. I've had no pain at all and still maintain movement.
    If you'd like to correspond more on the subject...just reply back. I too was so discouraged with all the pain that I considered amputation. I just wanted to be able to walk, hike, and jump again. There is good news on my results, but since your post was January 2007, I don't know where you are with things today.
    Wishing you the best.


    Old 03-24-2009, 08:46 PM   #4
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    Re: Comminuted Navicular with some serious consequences

    Hi Everyone,

    I just had a talonavicular/navicular cuneiform fusion on December 5th, and would love to talk to someone who has had a similar surgery. I know these posts are old, but if anyone still checks this I would love to hear your story and how you are doing.

    Here is my story:

    In August of 2006, I was riding a horse that slipped on wet grass and fell down onto my right side, and the stirrup completely crushed my navicular bone. I had surgery to repair the bone - the surgeon used 2 screws. I recovered but it was never right and it got progressively worse over the next two years. I limped around in pain for as long as I could stand it (I was riding horses for a living, and was on my feet doing physical labor all day/in the saddle, so the pain just became unbearable) I went back to my surgeon who recommended removing the screws to start, but that I would probably need a fusion, but to get other opinions. I went to 2 other surgeons and was told by both that a fusion in my case was inevitable. I ended up going with one of the new doctors for the surgery. She injected the talonavicular, navicular cuneiform, and the joint above that to isolate the pain and determine which ones to fuse. We decided the 3rd joint did not need to be fused.

    I had the surgery on December 5th, and it went very well according to x-rays and then a CT scan 8 weeks after surgery. I am still in the walking boot, but am trying to slowly wean out of it into a shoe (doctors instructions) I have been finding it very diffcult, painful and frustrating. My surgeon led me to believe I would be back to somewhat normal activity by now (its been almost 4 months), and I feel like I am no where near that point. I am having alot of pain when I try and put weight on the ball of my foot, so I am now waiting for custom orthodics to come in, which the doctor thinks should help.

    I am just curious how long this recovery actually takes, and when I can expect to be walking around somewhat pain free/comfortably? From reading some of these posts it seems like 9 months to a year for pain free. Any advice/thoughts?

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