Calcaneus Surgery ORIF Success Stories?

Steve sleo@global.co.za wrote: Good going Candee and pleased to hear the arm weights worked out OK. I worked out my upper body nearly every day and it did wonders for my mood and sanity. How's your dad doing? It's been a year since my operation where a plate and 10 screws were inserted. Today I walk OK and get stronger every day. It's stiff and weird most days, but I guess that's the way it'll be. My calf is still less bulky than the other, but I'm working on that. I'm trying to walk barefoot around the house which is a little uncomfortable but workable.
Bryan, when you experience arthritis, is it painful or stiff? In other words, what does arthritis feel like?
Pete, I hope the PT is still going well and you're all good.
Joe, same goes for you and hope everything OK.
Keep smiling guys! 

Steve it feels a bit stiff on my foot/ankle area but after a few steps it breaks in type of thing.  If the weather changes so to say it is a dull pain and sometimes it is my whole body so part is just age (55).  But no limping like before.  

Or after a long day or week it is the same dull pain that we all get from time to time.  I will say vs when I had the hardware I would wake up middle of the night sometimes or would simply limp to get ready to work.  Once up and around the pain is gone and it feels like it does now.

So with just the arthritis (no hardware now) it is very tolerable but with the hardware and the issues of the screw backing out just a thread eventually became to much leading to removal.  Now it simply it is what it is and everyone has these type of things.  

Thanks, Bryan and Steve.  My dad is doing good. Still in a little pain but getting better everyday.  I really hate to sound so selfish, but I did tell my sister that I’ve never been so jealous of someone else’s injury since he’s full weight bearing already, with a walker for stability.  Have either of you had the crazy nerve pain?  My sister and a PT friend of mine said I should ask my dr about neuroten for nerve pain. I still have some pain medicine left from the initial surgery, but was thinking I should save it for  when I start PT .. any thoughts?  Did y’all have to take something for the nerve pain?
You both sound so good.  It really does make me so hopeful!  

Thanks Bryan, I also get stiff in the ankle and foot, so I guess that's arthritis. I don't get all over body pain. Maybe it's from a lot of stretching I do at the gym most days. Anyway, I am close to your age, so the creaky bones are part of life at this age! There was a great stretch my PT gave me last week, which is standing with both feet at a 45 degree angle (he has a wooden angle stand for this), but one can use anything similar. Both feet upright and stand upright stretching the achilles and calf muscles - 30 secs, then relax for 30 secs. Then feet 45% to the left and then 45 degs to the right, using the same sequence. It has really loosened my calf and achilles.
Candee - I don't recall nerve pain, just weird electric type shots in my foot now and again which have now stopped. Might be an idea to consult our doc.
PT didn't hurt, but does feel uncomfortable at times. My PT concentrated mainly on getting my swelling down which was way out of hand. She used dry needling (western version of acupuncture) all over my leg and foot to open the channels. It worked. I'v now started with a new PT (12 months down the line) as he believes he can get more range of movement out of foot. I'll have a few sessions and see how it goes, but basically I'm walking ok and playing golf.
All the best!

Thanks Steve.  I was hoping I was through with the pain med part of this, but I’m trying a half pill this morning.  I’ll call my dr tomorrow and see what he says.  
Pete, I’m ordering those compression socks today. Hoping that provides a little relief.  

Small update, cut the grass today,took me like 2 hrs but good for the leg .since ground not level ..

Also, up and down got better and can move left to right bit more but still nothing like the good leg ,
ROM is the hardest thing on this, and curling toes down .

God bless you all,

Pete, that is awesome!!  

Well done Pete! Serious progress!
I have to say that I have found walking is the best way to build up your leg in all ways. I have been a little scared of walking too much, even though I am 12 months post op.
However, we are on holiday at present and walking about 14000 steps per day for exercise and my foot is loving it. My calf has built bulk which it didn't do from calve raises in the gym and my foot has loosened up big time. Overall walking seems a good exercise for the foot and the brain too!!
Candee, how you doing?
All the best.

Steve, I’m good.  I’ve had a little more pain this week than I wanted.  It’s not in the heel area, but it’s on the top middle of my foot.  I’m ready to see the dr.  I’m sure it’s just part of this whole thing but it makes me nervous.  It almost feels like it needs to pop...  I don’t want any setbacks.  I’m ready to walk (even though the thought of actually doing it scares the crap out of me!).  You sound great!!  14k steps sounds amazing!!!  I know your family is so happy to have you back!! Enjoy your time.

Candee, I am not sure of that pain - never had it. When you do start walking, it will definitely be weird and you might require silicone heel pads or suchlike. Remember, the name of the game is to start slow and build up.  Good luck!

Steve, I’m not sure. I’m hoping soon, but will find out Tuesday.  I’m getting impatient!  

 I hope you all have a good weekend , Steve good to hear from u again ,Candee this is going to be up and down recovery,,you'll get there we all do just a metter of time and how much close we can get back to normal.
Still working on my leg i walk allot,i say walking on grass is good just gotta do it slowly.. ROM is whats hard about it..

God bless you all,

Pete, so glad to hear you are walking a lot!  Even on grass!  Have a great weekend.  

john gregory wrote: I am a surgeon who performs this surgery and a lifer climber.  happy to answer questions directly or even review xrays etc...Bottom line with this fracture is the damage to the cartilage and the joint and how well that can be put back together.  if the joint isn't broken and alignment can be repaired, then return to active life is possible. Younger, healthier (people) joints fair best.  The other challenge comes if there are other injuries/fractures sustained at same time further delaying recovery.  Bone takes 6 wks to heal and most people take 6-12 months to total rehab.  

Dear Dr. Gregory,
You are very generous to offer. I'm hoping you'd be willing to give me an opinion.
 
 I'm a 33yo female, former D1 All American water polo player and D1 swimmer. I only splash around in the water these days but I was running 3mi approximately 4 days a week at the time of my injury. I'm in the healthy BMI range. No other health conditions.
 
 On June 15th 2019 I fractured my L calcaneus after a 20 foot jump into water that was too shallow. On June 18th I fractured my R calcaneus during an attempt to use crutches to go down stairs - I estimate a 1.5-2 foot drop and I felt the crack in my heel immediately upon hitting the floor. Of note, the hospital imaged my R foot on June 15th after I broke my L calcaneus and my right foot was 100% intact, implying that the short fall down the stairs is truly how I broke my R foot. Radiologist reports for both heels are the same - "nondisplaced comminuted calcaneal fracture."
 
 Orthopedic consult occurred 6/24/19 and recommended conservative management but acknowledged that a podiatrist may know more about these types of injuries. Podiatrist consult occurred on 7/23/19 and he commented that he would have use a percutaneous surgery for the R foot and agreed with conservative management on the L foot (noting that it's too late for surgery now). He reasoned that the left foot was more complex and would require a more invasive approach that is risky and for only questionable benefit compared to conservative management, whereas he could use a less risky percutaneous approach for the right foot with more confidence of achieving greater benefit in comparison to conservative management.
 
 I never got a CT but my podiatrist is currently obtaining authorization for one. We're also doing repeat xrays. I return to see him on August 8th, he'll tell me what he thinks about the new films and radiology reads at that time. I'm currently non-weight bearing. I have a trip planned on August 25th and I only want to go if I can walk at least one mile at any speed (slow is just fine). My podiatrist said I'd be able to walk though I will have pain, and to keep the trip booked. I can cancel with no penalty (it's an AirBnB).
 
 Any thoughts would be so appreciated. I can email you the images if needed.

Sincerely, Alex

that is an unfortunate history.  never had a pt break both heel bones at different times back to back. ugh.

the right posterior facet STJ appears aligned, but need CT of both to truly know.  the crux is the posterior facet alignment.  

Left xrays are unhelpful regarding posterior facet alignment assessment.

it has been too long to consider true surgical reduction if CT reveals deformity. if so, only option from here will be fusion.  

regardless, you will be able to walk for your vacation, but level of pain will be based on level of alignment of sub talar joint.

sounds like you have good support.

hope that helps.  sorry for your injuries.  

That subtalar joint.  Hello my fellow club mates, I just wanted to take a second and wish you well. Still living the dream over here in Utah.

All healed up from hardware removal but my darn foot. And that damn subtalar. :( I'm too young to be like this.  I hope you all have a stronger psyche than me.  I've had some 13000 step days, I'm able to walk afterwards but it seems as if I'm in for a lifetime of intense pains and weird walking.  As a caveat those of you that are in early recovery I can say it gets better, it just doesn't get normal again. At least when you have a Sanders three to four.

Best wishes to all.

Hey Jeff good to know u doing better,and t keep stopping by to help others..
Myself i walk and still go pt for another 4 weeks (my choice)  just the ROM
it's hard to get it going more hope not for long.

God bless you all,

john gregory wrote: that is an unfortunate history.  never had a pt break both heel bones at different times back to back. ugh.

the right posterior facet STJ appears aligned, but need CT of both to truly know.  the crux is the posterior facet alignment.  

Left xrays are unhelpful regarding posterior facet alignment assessment.

it has been too long to consider true surgical reduction if CT reveals deformity. if so, only option from here will be fusion.  

regardless, you will be able to walk for your vacation, but level of pain will be based on level of alignment of sub talar joint.

sounds like you have good support.

hope that helps.  sorry for your injuries.  

Dear Dr. Gregory - I so appreciate your input. I'm hoping so much that the posterior facet is aligned, because the thought of fusion at this age after living such an active life is honestly unbearable. I will have to wait and see. I'm salty that my ortho didn't order a CT...seems a bit unconscionable since that was clearly needed for an accurate assessment. A few questions about pain - do you think that pain experienced in the joint is experienced and feels differently than pain experienced in the heel pad itself? I imagine it is, but I just have no idea because I've been nwb. I don't know why it matters, I guess...I'm just curious and pretty scared. Thank you so much, again. I know you don't have to do this and I consider it such a favor from the heart.

john gregory wrote: that is an unfortunate history.  never had a pt break both heel bones at different times back to back. ugh.

the right posterior facet STJ appears aligned, but need CT of both to truly know.  the crux is the posterior facet alignment.  

Left xrays are unhelpful regarding posterior facet alignment assessment.

it has been too long to consider true surgical reduction if CT reveals deformity. if so, only option from here will be fusion.  

regardless, you will be able to walk for your vacation, but level of pain will be based on level of alignment of sub talar joint.

sounds like you have good support.

hope that helps.  sorry for your injuries.  

Hi John, I was hoping you could look at my xrays and give me your input on the long term prognosis of my foot. I have a valgus deformity and I'm still having pain in my foot that likes to move around but mostly in the heel (sharp pain). Do you think my foot needs surgery? I will post xrays of my calcaneus when it was broken and after it was healed. I appreciate any of your input. Thanks !! - Maddie 

do you think that pain experienced in the joint is experienced and feels differently than pain experienced in the heel pad itself?  yes, they would be different.  subtalar joint pain usually side of foot just below ankle malleolar bones.   hope that helps.

mims, based on these Xrays, yes I think you need surgery.  really need Weightbearing views and CT to better determine extent but likely fusion and calcaneal repositioning.  are all of your tendons intact/functional?