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  • Calcaneous fracture complications

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    Old 07-04-2009, 04:40 AM   #1
    Gperet
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    Calcaneous fracture complications

    Hi all,

    I'm a 50 yo male in otherwise good health. In the first week of January 2009, I suffered an accident falling into trench in the middle of a pedestrian walkway. As a result, I suffered a (closed) fractured calcaneous (seen only on MRI). The orthopedist put a plaster cast on my foot up to my knee for 6 weeks. After, he changed the cast with a new one, and told me to where that another 6 weeks. The pain was still bad, but the doc said after the first 6 weeks I may put pressure on the foot He also ordered a CT scan. The scan showed that the fractured has not healed, but is mending very slowly in an incorrect manner.

    I found a new orthopedic foot surgeon, who said that I should have had surgery within 4 weeks of the accident, to install hardware. He recommends surgery now, which would be either a bone graft or an osteotomy. If not, he said that osteoarthritis will settle in fast and there would be major trouble ahead.

    I'm sure I'm not the only patient whose calcaneous fracture was put into a cast without any surgery, but requires same sometime later. Is there a preferred surgery? What can I expect after the surgery as far as pain and recovery time? I would appreciate all advice. Thank you.....

     
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    Old 07-04-2009, 07:46 AM   #2
    tchair
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    Re: Calcaneous fracture complications

    Hi Gperet,

    You have come to the right place. It happens to be the 13th anniversary of my surgery and the group presently posting here is the best and most knowledgeable I have seen to date. Unfortunately they all seem to be sleeping in today, but you can expect them to reply shortly, providing a wealth of information.

    You are correct that others have had to find a new doctor to properly diagnose and surgically correct the fracture. You were smart to move on to get good care. (Plain x-rays should have been enough for a competent ortho at the time of injury.)

    There is a standard break from a fall - resulting in a diagonal fracture with the extent of that into the joint and number of pieces depending on the force involved. There is a standard 'lateral approach' surgery from the outside of the foot which allows access to the joint and fixation with plate and screws while avoiding damage to nerves and tendons. The bone graft and osteotomy are also fairly standard. Other causes such as motor vehicle accidents can cause different fracture lines resulting in different approaches, but you can expect the same distinctive Heelies "L" shaped incision.

    Running late will be a setback with many more weeks of non-weight bearing. But you have the benefit of having allowed time for the soft tissues to repair themselves. As far as pain - or in correct medical parlance "discomfort" - yes it is quite invasive surgery, but separated from the initial injury should not be severe. I will leave it to those with a more similar experience relate their views. When it comes to medications remember that they are necessary in recovery. Just as a cast and crutches, use them as needed with no qualms, knowing that they are simply appropriate tools that perform a needed function.

    Your extended down time leads to some concerns that you will want to cover with your doc. First and foremost is circulation. Muscle use is a mechanical part of blood flow. Ask what you can and should do what you can do pre and post surgery to enhance the circulation to the foot and therefore healing. With the foot immobile the Achilles’ Tendon tends to shrink so you will want guidance on preventing that. I see from your other post that you also sustained a knee injury. While your body will be repairing itself, the docs will intervene where needed, you also need a plan of what you will be doing to provide the best results.

    Tim

     
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    Old 11-24-2010, 04:52 AM   #3
    Gperet
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    Re: Calcaneous fracture complications

    Quote:
    Originally Posted by tchair View Post
    Hi Gperet,

    You have come to the right place. It happens to be the 13th anniversary of my surgery and the group presently posting here is the best and most knowledgeable I have seen to date. Unfortunately they all seem to be sleeping in today, but you can expect them to reply shortly, providing a wealth of information.

    You are correct that others have had to find a new doctor to properly diagnose and surgically correct the fracture. You were smart to move on to get good care. (Plain x-rays should have been enough for a competent ortho at the time of injury.)

    There is a standard break from a fall - resulting in a diagonal fracture with the extent of that into the joint and number of pieces depending on the force involved. There is a standard 'lateral approach' surgery from the outside of the foot which allows access to the joint and fixation with plate and screws while avoiding damage to nerves and tendons. The bone graft and osteotomy are also fairly standard. Other causes such as motor vehicle accidents can cause different fracture lines resulting in different approaches, but you can expect the same distinctive Heelies "L" shaped incision.

    Running late will be a setback with many more weeks of non-weight bearing. But you have the benefit of having allowed time for the soft tissues to repair themselves. As far as pain - or in correct medical parlance "discomfort" - yes it is quite invasive surgery, but separated from the initial injury should not be severe. I will leave it to those with a more similar experience relate their views. When it comes to medications remember that they are necessary in recovery. Just as a cast and crutches, use them as needed with no qualms, knowing that they are simply appropriate tools that perform a needed function.

    Your extended down time leads to some concerns that you will want to cover with your doc. First and foremost is circulation. Muscle use is a mechanical part of blood flow. Ask what you can and should do what you can do pre and post surgery to enhance the circulation to the foot and therefore healing. With the foot immobile the Achilles’ Tendon tends to shrink so you will want guidance on preventing that. I see from your other post that you also sustained a knee injury. While your body will be repairing itself, the docs will intervene where needed, you also need a plan of what you will be doing to provide the best results.

    Tim
    Unfortunately, I did see your response until TODAY. I thank you very much for the time and effort it took in preparing this. I wish you all the best!

     
    Old 11-24-2010, 05:58 AM   #4
    tchair
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    Re: Calcaneous fracture complications

    Quote:
    Originally Posted by Gperet View Post
    Unfortunately, I did see your response until TODAY
    That's OK, just been sitting here patiently for a few months
    Its good that you made a separate post about your STJ fusion so it gets noticed. My thoughts are that those who's docs guessed it would help had mixed outcomes on pain reduction while those who's docs - like yours - pinpointed it as the cause were very pleased with the results. I'm guessing that large cast and 8 weeks are playing it safe due to your previous healing time. Good luck and keep us posted.

    Tim

     
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