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  • Navicular non-healing: to have surgery or not to have it (that is the q...)

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    Old 08-26-2008, 05:41 PM   #1
    beanstock
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    Navicular non-healing: to have surgery or not to have it (that is the q...)

    I have a navicular stress fracture, and on June 4 I was put in a cast and on crutches. At five weeks, because the foot looked and felt good, they gave me a NWB boot. At 8 weeks, I was given permission to bear weight, and so since the end of July I've been walking and riding a stationery bike. The foot feels great, almost no discomfort, and the swelling is significantly reduced. I began PT with little discomfort and good progress.

    This week I had a CT scan and it showed non union. The doctor was very surprised by this since my foot has responded so well and looks good. The scan shows good blood flow to the bone, but it's just not healing. She suggested surgery, but also said I could consider a bone stimulator.

    Does anyone have experience with this? Do they actually help? The research seems iffy at best. I most certainly do not want surgery, but what I want even less is to waste six more weeks hoping that a bone stimulator might help, only to discover that it hasn't and that I need surgery after all. On the other hand, is there a chance of non-healing post surgery? And what then? I just don't even know how to begin to make this decision.

     
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    Old 08-26-2008, 06:23 PM   #2
    badfeet51
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    Re: Navicular non-healing: to have surgery or not to have it (that is the q...)

    I am having surgery tomorrow on a failed fusion, in other words a non-union that the doc has been working on since march 21. This will be my third attempt and he is going to put a bone stimulator on at the time of surgery. I will let you know all I find out about it sometime this week. Keep your post going so I can find you.

     
    Old 08-26-2008, 08:19 PM   #3
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    Re: Navicular non-healing: to have surgery or not to have it (that is the q...)

    Beanstock,
    i wrote a while back that after months of delayed union and then ORIF, that i was showing signs of healing. Had an x-ray yesterday (7 months post op) and it seems that there is no healing after all. The last x-ray must have been taken on a poor angle. So i had the surgery and still have non-union. But i didn't have a bone graft. Just two pins. I questioned this prior to my surgery, and was told that i didn't need a graft, that compression and immobilization,was all that was required. And the surgery was 3.5 months after diagnosis. So here i am more than a year since i started with this, and one surgery later, no further ahead.

    I would suggest that you consider the surgery sooner than later. The longer the bone remains unhealed, the more likely that non-union will remain a problem. But question what the surgery entails. I read lots of articles that indicated that a graft with internal fixation would be the best approach for a delayed union or non-union.

    I am now on a list to see a specialist that occasionally comes to our city from a larger city. And will have an MRI. Who knows how long that will all take.

    Good luck.
    Keep us posted.

     
    Old 08-27-2008, 06:14 AM   #4
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    Re: Navicular non-healing: to have surgery or not to have it (that is the q...)

    Hankster,

    Wow. I'm really sorry to hear this. I do remember you writing a few months back, and you said that you'd finally shown some signs of healing. I also recall that you were very active pre-injury -- you have got to be frustrated beyond belief. I know am and I havne't yet endured anyting close to your experience.

    My x-ray, too, showed healing, but like yours, it must have been on an off-angle.

    I wish you the best, and hope you will keep us posted. I will do the same. Who freakin' knew that one little bone could cause so much agony? More the emotional sort than the physical, at least for me. I've been remarkably pain free. But still in jail...

     
    Old 08-27-2008, 09:32 AM   #5
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    Re: Navicular non-healing: to have surgery or not to have it (that is the q...)

    To share my experience with a bone stimulator, I had surgery for a midfoot fusion in 2005 which resulted in a non union. To redo the surgery, my surgeon used a bone graft the second time. He also used screws vs. staples. after the surgery, I got a bone stim (insurance would not pay for it!) and used it right away. Luckily, I got a successful fusion this time. I would recommend getting a bone stim. but I had a horrible time with my insurance co!
    Good luck!

    Diane

     
    Old 08-28-2008, 09:50 AM   #6
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    Re: Navicular non-healing: to have surgery or not to have it (that is the q...)

    Hey Hankster -- or anyone else who has had this -- is the surgery to fuse the navicular bone done on an outpatient basis? I would assume so but I haven't been told either way by my doc yet.

     
    Old 08-28-2008, 11:39 AM   #7
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    Re: Navicular non-healing: to have surgery or not to have it (that is the q...)

    i had a calcaneal osteotomy where my doctor added bone graft to my foot, and after several months of the bones looking good, i had a non-union. after ayear on a bone stimulater and nothing, i had no choice but to have it re-done. I had it re done about 14 months ago and am facing the same thing, non union. For me bone stimulaters havent worked well, and neither has surgery for that matter, but i am extremely rare. bone stimulaters are supposed to be pretty successful and so is surgery it depends on the person however.

     
    Old 08-29-2008, 06:24 AM   #8
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    Re: Navicular non-healing: to have surgery or not to have it (that is the q...)

    my surgery was an over nighter. But i got sprung that night. I would have been staying in the OR ward, not actually admitted to a room upstairs. And the stay was so that i could have three doses of IV antibiotic drugs. But the nursing staff is very sympathetic to getting people into their own beds where they would rather be. So they allowed me to leave at 11:30 that night after i had all my drugs. Several things ...I had some one to stay with me. I had a spinal anestetic, not a general. And i wasn't feeling sick. Also this was for screws, not a grafting as well, which i belive would be more involved, and i expect more painful.

    As to the bone stimulator. I did have a go with one prior to my surgery. With no apparent result. Also what i read indicates that they are proven for some fractures, but not the navicular. I read one antidotal case where a collage basketball used one on his navicular fracture and returned to play quite quickley. But there are no stats on it for the navicular.

     
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