Calcaneus Surgery ORIF Success Stories?


Original Post
BrianLee · · Austin, Texas · Joined Jun 2014 · Points: 150

Hello, has anyone undergone Calcaneal Surgery that required the insertion of hardware, and if so did you fully recover? What I mean is, were you able to continue climbing and hiking with full range of motion and minimal pain after the surgery?

I had taken a ground fall and shattered my calcaneus, including fracturing my subtalar joint. I'm sitting here several weeks after the surgery and just looking for hope in the form of optimistic stories of others who have had the same experiences.

Thank you,
Brian

chrispatrick · · Unknown Hometown · Joined Nov 2012 · Points: 0

Hey there Brian. I took a 50 foot ground fall and severely shattered my calcaneus about a dozen years ago. I had a plate and 10 screws put in. I was back to technical climbing about 1 year after the surgery. I can still climb and hike but my range of motion is very limited (can't really move my ankle left to right). To be honest I don't really notice it much while climbing except when I'm torquing that foot in a crack. I found that my body adjusted and compensated to the limited range of motion. It locks up every now and again(arthritis) but I am grateful that I only broke my heel.

BrianLee · · Austin, Texas · Joined Jun 2014 · Points: 150

Hi Chris thank you very much for your reply,

Do you remember if your subtalar joint was fractured at all? I took a fall half the length of yours but fractured my subtalar joint as well. Right now I'm in a cast and trying to remain off my damaged foot.

Were you able to hike a year after the incident like normal or was there a long downtime where you remained not active on your foot?

RickThalacker · · Unknown Hometown · Joined Jan 2006 · Points: 5

Shattered mine 8-10 years ago, 8 screws and a plate. Bothered me a bit for the first year or two, mainly traversing in crampons, golf swing and pedal bike. Now hardly ever think about it unless a long day with the points on. Rock climbing never bothered me much, even crack and offwidth.

chrispatrick · · Unknown Hometown · Joined Nov 2012 · Points: 0

Hi Brian. My break was just the heel. No other bones were affected but the doctor said my heel was in over 100 pieces. He described it as a dinner plate dropped on concrete : ( After the long healing process and P/T I kinda eased back into things. Hiking was strange at first because I lost some range of motion, but after a while I actually got used to it and knew what my limitations were. Uneven ground and traversing hilly terrain was the major challenge. Overall It hasn't kept me from doing anything. It just changed the way I go about stuff. It's kinda hard to explain. In a couple years you will know exactly what I'm talking about. Since my accident I started wearing boots with ankle support for long approaches. I found that was very helpful. By the way, when you are doing all the p/t and rehab make sure to stretch the shit out of your achillies as much as possible. It will hurt but all my doctors told me that was the most important part of recovery. I believe they were right. Heal up quick Brian. If you have any other questions I'm happy to help.

BrianLee · · Austin, Texas · Joined Jun 2014 · Points: 150

Rick, that's great to hear and makes me more optimistic about the long term,thanks.

Chris, my heel was in several pieces and cracked like an egg is what i was told. I do hear that uneven terrain is challenging after the calcaneus has been damaged like you had described which sounds worrying to me, but I'll just have to experience it. I'll be sure to stretch my Achilles when I'm at that stage. I'm very glad to hear that the surgery hasn't prevented you from climbing and hiking. That gives me a lot of hope, thank you again.

Scott E. · · Unknown Hometown · Joined Aug 2010 · Points: 20

Hey Brian. I had a Sander's Type 3 AB severely commuted interarticular calcaneal fracture (probably botched those spellings) that required ORIF surgery with a plate and nine screws. Pretty bad situation. I was freaked out pre- and post surgery.

Don't listen to any of your docs telling you what you won't be doing in the future. Just do it. Be smart and do tons of PT. But don't be timid or self-doubting. My ordeal was about four years ago and I am by far much stronger and more active now than ever before. It has not affected my climbing at all and I have done more, and more intense, backpacking with a very heavy pack than I ever did before. I also started running AFTER my surgery-recovery-PT. Yes, I do have some range-of-motion issues but it ain't nothing but a thang. Really, it's not a big deal. It's probably best to STOP researching how horrible this is going to be on the internet. That freaked me out bad.

I also had all of that hardware removed. A decision that I do not regret. You will get through this. Hunker down and re-watch your favorite climbing vids, read some good books, and take what you've researched on the internet as rare worst-case scenarios.

You will really enjoy doing the one-legged climbing during your re-hab time!

Ha!! I just checked out your profile pic. I thought that looked familiar. I live in Tucson and know Steve's Arete well!

BrianLee · · Austin, Texas · Joined Jun 2014 · Points: 150

Scott, I'm very interested in your decision and result of having the hardware removed, which did not even cross my mind. How long after your initial surgery(the ORIF where the hardware was inserted) did you wait until you had the plate and screws removed?

Your success story really made me more optimistic about continuing to climb and remain active after all this passes.

Thanks for checking out my photo! I visited Arizona several weeks ago and may even move there in the near future. The landscape there sure beats the hill country area I live in here in TX.

Scott E. · · Unknown Hometown · Joined Aug 2010 · Points: 20

Brian, I lived many years in Austin as a student at U.T. Also, my fracture was also described as "cracked like an egg." (And that's kind of what it sounded like when it happened...no, actually it sounded like a branch snapping.)

Hardware removal: It was something like 9 months post ORIF, but my memory is a bit vague on that. I went through ORIF, recovery, and PT. During PT it was discovered that I had also suffered previously undiagnosed tendon damage. Not a real big deal, but I had a second surgery to repair that. I jumped on the opportunity to have the surgeon remove the hardware during this second surgery. It did require opening up the original surgical incision again, and you know that is a big deal (big incision.) And it required another recovery period, but not as extreme by any means as the first. I am very happy I did it. Of course I have no way of knowing if things would be different with the hardware still in there.

Which leads to your inquiry about the result of having the hardware removed. That surgery was in the winter. That summer I climbed Royal Arches in Yosemite.

I was seriously bummed when the first potential surgeon for the ORIF (who had very poor bed-side manners, as they say) told me all of the "you won't be able to walk on uneven surfaces" story and the canned advisement against ever trying to climb again. He freaked me out pretty bad. I got home and called back and cancelled that surgery, found a different surgeon to see and had him do the surgery. This second surgeon walks into the room to see me and asks me where I was climbing. I'm thinking that he expects me to say that I was climbing a ladder to get on to my roof or something since that seems to be the way most of these fractures happen. I respond that I was rock climbing. He says he knows that, but where? I'm thinking, why do you care? But I tell him at the Cochise Stronghold. He says where "at the Stronghold?" I'm curious now so I respond "at Zappa Dome", wondering why he wants to know. He says "Oh, yeah, I was climbing there a couple of weeks ago."

Haha. Turns out he is a climber. Turns out he regularly climbs in the gym here in Tucson where I climb. Good feeling.

Shit Brian, what do you mean "be more optimistic about continuing to climb"! Do you enjoy climbing?? My guess is that the answer is probably yes. Then why would you not continue to climb? The shit you're hearing about becoming a retiring couch potato is coming from people that are perfectly ok living that lifestyle themselves. Believe me, you and I are not suffering anywhere near the hardship that some people out there do that continue to challenge themselves to attack intense physical challenges well beyond "continuing to climb"

Have you read, or seen "Touching the Void", Joe Simpson? If not do so very quickly. Now that is suffering! Didn't stop him. Another good one to read is "Kiss or Kill" by Mark Twight.

Good luck. You will be fine. Don't hesitate to continue the conversation if you want to.

BrianLee · · Austin, Texas · Joined Jun 2014 · Points: 150

Scott,

That's cool that you used to live in Austin,TX as well and I imagined you climbed at Reimer's too? I'd still prefer Mt.Lemmon over the limestone here.

It's probably hard to say but if your tendon had not been damaged would you have gone with a surgery specifically to remove the hardware? It does make sense that you had the two performed at once.

Well your climbing in Yosemite post surgery sure shows that the calcaneus damage doesn't prevent one from going big. That's sure inspiring. I haven't seen "Touching the Void" yet, but will do so after the recommendation.

I just had my cast removed today and was happy to see that although my range of motion is limited I was still able to rotate my foot more than I had expected. My Achilles is very tight but I just have to continue stretching. One of my initial doctors was also a rock climber had a genuine interest in what particular wall I had fallen from at Reimer's Ranch.

Thanks again!

Nick F · · Unknown Hometown · Joined Jan 2016 · Points: 0

Thanks so much for all your stories.. I'm having surgery next week and have been very concerned about range of motion, uneven surfaces, etc. I imagine that a lot of people who post and spend their time in fractured calcaneus forums are examples of worst case scenarios and people who are content with a more sedentary life.

Inasmuch as my recovery is up to me, twelve months from now I'll be doing everything I did before.

Bckpkr-Rachael · · Unknown Hometown · Joined Jul 2016 · Points: 0

Hi, all:

Thank you all for your posts! Such great information and success stories. Much better than some other forums that seem very depressing and only give me hope to mow the grass again.

I broke my right calcaneus and had a fairly uneventful surgery on May 11th - compliments of the Warrior Dash. It is so encouraging to read of your recoveries and journeys along the way. My surgeon sounds like he fits into the same class as some of the others and really preaches the doom and gloom outcome. Things like "this injury is a game changer" and "it's the gift that keeps on giving - and not in a good way." He basically said my job as NICU nurse and standing on my feet for 13 hours each shift was caput, not to mention getting back to hiking and backpacking. However, never one to listen to naysayers, I'll keep right on going and strive to get back to my baseline - better, if I have my way! That being said, I will not be adhering to my surgeon's advice to go and sit by a pool in a tropical destination in lieu of going to Badlands, Yellowstone, Grand Teton, and Rocky Mountain National Parks this month. My backpacking plans have obviously changed (I'm still non-weight bearing), but I'll be front country camping using my KneeRover/crutches and doing it with bells on! The mountains are calling and I must go!

BrianLee and Nick F.: if you still frequent this forum, how are you both doing about 6 months and a year post-op? A shout out to the veterans who've been living a grand life after their fractures many years ago!

Best,

Rachael

Nick F · · Unknown Hometown · Joined Jan 2016 · Points: 0

Thanks for asking.

Six months in and my results are mostly good. I didn't rush the weight bearing and started physical therapy as soon as I got the go ahead.

Three months and three weeks after the surgery I flew to Hong Kong and back. While we were there my iPhone registered nearly 20 miles of walking. My foot was sore as hell after that but it held up and was fine after a couple of days. Typically it is most sore after I've been sitting awhile; long drives or movies tend to do that, but after walking a minute or two it feels normal. Long walks with low to no extra weight have been the most helpful thing to do.

I can do everything I did before: hiking, elliptical machines, biking, weight training (squats etc.) I didn't run/jog much before but I've tried it a couple times in the last month and it was fine.

Today I balanced on my right foot with my whole foot on the ground and then stood up on the ball of my foot, full weight on that one leg. It was a little painful but I was able to do about five reps of that. Today was the first day I was able to do that.

My surgeon acknowledged that because I was in better than average health before the accident I've had a faster and more complete recovery than most could expect.

Psychologically I am grateful for the injury actually. This was the first injury I've had that will (in some small way) be with me the rest of my life and it changed the way I've spent my time. I've published several e-books on Amazon and have more coming and am way more purposeful in my day to day life.

My right foot will never be the same as it was or quite as flexible/dependable as the left but so long as I don't develop ambitions to be a ballet dancer or a marathon runner I don't feel limited at all.

Scott E. · · Unknown Hometown · Joined Aug 2010 · Points: 20
Nick F wrote:Typically it is most sore after I've been sitting awhile; long drives or movies tend to do that, but after walking a minute or two it feels normal.
Haha!! Spot-on and so true! This fades over time. But more importantly, once you come to understand the game you just DO NOT LIMP in those first few steps and your ankle bucks-up and gets it's act together very quickly.

Rachael, (reminder, I had a VERY BAD calcaneal fracture) I have worked countless shifts of countless hours on my feet in kitchens, post injury. Long periods of time on my ankle has never been an issue. As Nick said, this injury will in some way be with you for the rest of your life. Hell, you've got a big scar if nothing else! It's been probably six years or so since my injury and I do still acknowledge it at some level every day. But it has never been anything like a game changer in my life...not even close. I just took yet another grand backpacking trip in the San Juans, heading up fourteeners. And I climb far harder stuff now than ever before.
Bckpkr-Rachael · · Unknown Hometown · Joined Jul 2016 · Points: 0

Nick F. and Scott E., thanks so much for your prompt responses. It’s great to hear that you are recovering so well.

Nick: I can’t believe you were able to walk that far in Hong Kong so soon after your surgery! That’s incredible! While I don’t log that number of miles when at work, five miles is the norm with each shift, and three shifts/week. There’s not a lot of sitting.

My surgeon originally stated six to nine months before someone can return to an active job where a lot of standing/walking is required. He seems to have backed down and thinks that four months may be enough. I have to return to work unencumbered, e.g. no knee scooter, surgical boot, etc. I need to be able to move fairly quickly in the event that one of my patients crash or newborns need assistance or resuscitation immediately following delivery.

I just had my first visit with PT last week and go again on Monday. I’m hoping to see real progress as I ramp up with therapy. How soon were you able to walk following your surgery? My surgeon said between 10-12 weeks is when I can begin to walk. I didn’t routinely jog/run either, but our activity choices pre-injury sound similar. I couldn’t agree with you more on the gratefulness of the injury. I have an interesting medical history and I believe in living each day purposefully! I’ll have a look at your e-books!

Scott E.: Excellent advice on the limping; I'm prone to this already! The nurse in me loves reading about your complicated fracture, although four years is a lengthy recovery. It’s good to hear you’ve recuperated and how you are able to endure long shifts on your feet without any real difficulty. Your backpacking updates are also phenomenal! I vaguely remember being heavily medicated immediately before surgery and grilling the surgeon about my abilities to hike and backpack post-op. (Quite embarrassing after the fact!) I’d like to continue my JMT planning as soon as feasible. Your trail descriptions give comfort that uneven terrain is not a deal breaker!

JSH · · Unknown Hometown · Joined Apr 2007 · Points: 960

Rachel,

I blew up my calcaneus along with other injuries (burst L1), and originally got a plate with 7 screws. Injury was 5/21/2011. There was some talk that I'd lose the foot, but I seemed to luck out with trauma surgeons -- at my follow-up, the new doc said the trauma repair was done by "ninjas", and my subtalar joint still had great space.

My recovery was complicated and slowed by the compound nature of it all, so that's a big grain of salt. However, I was walking in a boot at 2 months? and progressed after that. My hardware got in the way of normal function, so most of it came out in 10/2011. The remaining two screws still hurt, so they came out in 2/2011, and I was walking pretty normally (and climbing) by May or so.

Finally, the retinaculum that held my peroneal tendon in place outside my ankle had been torn either in the original trauma or by the hardware; I knew it was torn, but I put off that surgery for 3 years (various reasons) and got it repaired in 12/2014. That surgery made a lot more difference than I expected -- I had gotten pretty good at compensating, including walking on uneven ground -- and things are really good now. Full ROM. Standing around for a long-long time gets it achy, but not terribly so.

Best wishes -- be patient! You'll get there.

RespectGravity HJ · · Unknown Hometown · Joined Sep 2016 · Points: 0

All,

Finally a forum that isn't doom and gloom. I broke both of my heels 1 month ago today. Underwent ORIF Surgery 3 weeks ago Monday.

So far, so good. I have been off all high strength pain medications, into walking boots yesterday.

Did anyone experience arch trauma or associated nerve issues with their broken heels? The doc is saying that this will improve over time, but so far no improvement. Currently this is my biggest concern to threatening my active lifestyle in the future...climbing mountains and adventure bike riding.

Again, thanks for all of the success stories. I think there are a lot of forums out their that are filled with overweight, out of shape people. I keep telling myself that I will have a full recovery based on what I was like before the accident.

Regards,

M

Jessica Seyller · · Unknown Hometown · Joined Oct 2016 · Points: 0

Hey RespectGravity!

Wow, both heels and already in walking boots?! Nice work! I was non-weight bearing for 3 long months post-op.

I've been trying to do some research into my post-op pain, because for the longest time (break was in May of 2013) I just assumed my pain was due to arthritis (have heard the whole "it will never be the same again, always going to have issues, life changing injury" comments from my ortho as well)...but the more I look into it and really focus on when/where the pain comes on the more I actually think it's nerve damage. My pain seems to be on the lateral and bottom of my foot vs ankle joint.

I found this article which discusses surgical approaches and resulting post-op nerve damage. My doc used the "direct lateral" approach which seems to have the highest probability of post-op nerve damage. My PT did a lot of dry needling to the bottom of my foot (had horrible arch spasm/cramps for awhile) and down my calf which helped a ton in the beginning of PT sessions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748881/

The pain isn't terrible, I'm more frustrated with the limited ROM, but even then I still pretty much do everything I was doing before the injury. Backpacked 17 days in the Himalayas up to 18,000 feet/ still go jogging/snowboarding/ deep squats in crossfit etc. There's not really a day that goes by that I'm pain/stiffness free, but it's a hell of a lot better than being paralyzed!

Hope the healing process continues to go well for you! Go hard in PT, I wish I could go back and put more effort into that in the early stages.

RespectGravity HJ · · Unknown Hometown · Joined Sep 2016 · Points: 0

Jessica,

Thanks for the reference!

I am glad you are back to doing the things that make each day worthwhile! Where in the Himalayas did you go? That sounds like an amazing trip. As for crossfit, it was never my thing, but weight training definitely was a big part of my life over the last two years.

It is easy with this injury to sit and worry about not being able to do those things in the future, but I'm staying optimistic.

I'm in the boots but I'm definitely not walking. I think the doctor is using them in place of casts. I can take my feet out, stretch them, and let my feet breathe at night. I will be in a pool in a couple of weeks for aquatic therapy, and weight bearing 2 weeks after that.

Your lateral pain seems to be from disturbing the sural nerve on the outside of the foot. I think it is the main nerve that they have to move in order to perform the surgery. I am experiencing a numbness on the lateral portions of my feet, although this doesn't seem to cause any pain.

As far as the bottom of the foot goes, I have no idea. I am experiencing sensational changes beginning in my arch and moving to the ball of my foot and into my toes of my right foot. My 2nd and 3rd toes cause me pain when I touch their tips...not sure what that is about. My foot also doesn't like it if is in contact with the boot, so Im working through getting used to the feeling of that.

My main concern is the recovery of these nerves. They don't seem to be getting any better, and I'm wondering if something isn't entrapped because of the trauma in my foot. My hope is that they recover enough to wear shoes comfortably and can feel enough for me to sense whatever surface I am on.

At any rate, I am taking this whole thing one day (realistically one week) at a time. I was planning to hike Mt. Whitney in the summer of '17. I may have to put it off a year and if I run into trouble, the guy who I was going to go with says he will carry me to the top if he has to.

M

Bckpkr-Rachael · · Unknown Hometown · Joined Jul 2016 · Points: 0

Hi, RespectGravity:

Sorry to hear about your bilateral fractures but happy to read about your positive attitude! I can’t believe you are already in boots! It is somewhat of a relief to hear you are not yet weight bearing! My surgeon touts himself as a “numbers guy” and wouldn’t even consider me being full weight bearing until 12 weeks. He has said he’s seen too many hardware failures and bones collapse as a result of premature ambulation that would then result in reconstructive surgeries. So, I did my time and began ambulating at 12 weeks as instructed. My best advice is to get an order from your surgeon for PT when the time comes. Do your research and if possible, find a facility that offers aquatic therapy. The water gives a great deal of control depending on depth and allows you to start partial weight bearing sooner (based on physician orders) since the environment is more controlled. This was the most painful for me and I am thankful that I was able to take my first steps in the pool. If you can’t find a therapist (large hospital may be a good bet and is where I completed my PT) but have access to a pool, let me know. I have a list of exercises and descriptions of each that I completed.

I am just shy of five months post-op and am doing great. I completed my national park road trip with no issues and began my partial weight bearing on this trip. I returned last week from New Mexico where I went hiking on the most uneven ground possible – not by design. It was a rocky trail (3-4” rocks) with 400’ elevation gain in a ¼ mile to get to a river where you had to further trek a few hundred yards in ankle deep water on rocks ranging from 3” in diameter to large boulders to get to some falls. In retrospect, this was probably not the smartest idea, but I was anxious to hit the trail again and see how I responded. The ascent felt great, as I have struggled with my Achilles tendon seizing up and significant swelling. Steep inclines stretch this and help greatly. This was outside of Great Sand Dunes NP. I then went to Bandelier and did quite a bit of hiking in this area with no problems. I agree with Jessica though and wish I would have gone a bit harder in the initial stages of my PT. I’ve noticed I, too, have some limitations with ROM although my subtalar joint was supposedly unaffected.

I can sympathize with the feelings of nerve damage, but depending on extent, this will improve. You are still very early in your post-op recovery. Bumping my toes created significant pain until weeks 10-12 and then it started to ease, although the area was still sensitive for a bit. The lateral numbness may be related to the incision alone. Having had a previous abdominal incision, I am familiar with the nerves severed during the process and the numb but non-painful feeling. You’ll get some of this back and I don’t necessarily think it will inhibit your feeling for walking/activity as you progress. (Strictly my opinion here!) I still do have some nerve damage and don’t have control over my 5th toe. Not necessary I suppose, but strange that I can’t completely flare my toes. No real arch issues for me, but I was informed on Tuesday I am suffering from Fat Pad Syndrome, which just means the fat pad beneath the heel was damaged, and it feels like there is no cushion when walking. Part of my hardware is scheduled to be removed next month and isn’t completely debilitating, but it feels like I have a perpetual internal blister that is a complete nuisance and does cause a fair amount of pain after being on my feet 3+ hours. However, all these issues aside, I just keep plugging away and I think that those who have strong resolve, as is evident on this forum, have a better post-op and post-injury outcome. Hang in there!

JSH – Sorry I seemed to have missed your post! Sounds like we have some similarities and I’m happy to hear things improved after your hardware removal. I have seven screws as well and an intact subtalar joint. The two in the back helping to anchor my Achilles tendon are the most problematic. I’m hoping this helps with some of my pain issues!

Charlotte abbott · · Unknown Hometown · Joined Oct 2016 · Points: 0

Hey ... so im not actually a climber , I'm hoping that doesn't matter , but I have in coon the fact I fractured my calcaneum falling from 10ft ! My activity in general is boxing , but I sustained this injury climbing .. locked out of my 2nd floor flat. I am 3 weeks post op (16/9/16) my injury date (28/8/16) so a long 18 day wait for my op . This wait played tricks on my mind & mental state, it still
Does to some degree . So .. I ended up with 10 screws & a plate .. was advised I can't box again this brought tears to my eyes .. I'm hoping I can put that answer wrong ! So right now post op , I have some flexible movement i.e. Up & down in & out , round & round , limited but it's there .. stretching the back is limited but also there .. it hurts if I knock my toes , but what I don't like is that I can't bend my toes at all lots of movement but not able to bend .. is it early days ? I just had my stitches removed 2.'days ago and go back in 4 weeks for the boot and weight baring partial .. my concerns right now are the fact it goes darker in colour when I'm up
On the crutches , it also feels like it's restricted with blood supply .. is it Normal for the early days .. I'm only 38 quite active work full time & fear i may never return to my normal life . I just got a mortgage too .. this site seems to have some great positive mental
Attitudes , which I see is pretty much the key to success in most cases .. I also had no feeling in my heel at all . I look forward to some wisdom from people who have similar experiences .
Thanks guys
Charlotte
( from England)

Guideline #1: Don't be a jerk.

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