Paging Tobra

[dewolf]

Tobra,

Wife has fractured her calcaneus. She is in a cast as it's a clean break. Tomorrow she is seeing a surgeon to asses whether they want to pin and plate it. If they do operate, how long before she will be back to normal and will the bone always now have a weak spot? She is very active and 50 years old.

Cheers
Scott

[Tobra]

It sort of depends on how exactly it is broken. If the Subtalar joint is looking good, maybe not. That bone tends to fracture into the joint, hence is surgically repaired. She is going to be non weightbearing on that baby for a couple of months. Knee scooter is handy, probably will want support stockings after surgery for her.

[dewolf]

Thanks mate. I really appreciate it. Should she keep it elevated when sitting for now.

It's actually fractured from that joint downwards.

[sc_rufctr]

Sounds painful. I hope the Missus gets better soon!

[dewolf]

Originally Posted by sc_rufctr

Sounds painful. I hope the Missus gets better soon!

Cheers mate. The opiates are sort of doing their job. Renovating a rental property and lost her balance on a ladder and just jumped off instead of falling off. Keep telling her she ain't friggin 25 any more.

[billybek]

No monkey roll?
Sorry someone had to say it!

Hope she is feeling better soon. My wife had a stress fracture from running and was very upset with not being able to run.
Foot injuries are very painful.

[recycled sixtie]

Originally Posted by dewolf

Tobra,

Wife has fractured her calcaneus. She is in a cast as it's a clean break. Tomorrow she is seeing a surgeon to asses whether they want to pin and plate it. If they do operate, how long before she will be back to normal and will the bone always now have a weak spot? She is very active and 50 years old.

Cheers
Scott

I am sorry to hear about your wife Scott. How did she break that bone?

[recycled sixtie]

Originally Posted by billybek

No monkey roll?
Sorry someone had to say it!

Hope she is feeling better soon. My wife had a stress fracture from running and was very upset with not being able to run.
Foot injuries are very painful.

I am sorry to hear about your wife's stress fracture. I was having a conversation with a 60 year old friend of mine about impact sports such as running. He stated that walking incurs a 1G on the feet and 2-3G while running. Cycling there is minimal impact so less risk of fracture. Of course it can get worse as a person ages.

I don't want to take away from dewalts thread but perhaps I should start another post about impact on the joints.

[Tobra]

There are a variety of titanium locking plates, with various ways of fixing the screws to the plate. Gives you a rigid construct, far superior to the old Synthes plates. One way this is done is to have the plate and the heads of the screws threaded. It is possible to have them lock up even if it is not quite square to the plate surface, very groovy



Yes, elevate the foot. That higher than the heart nonsense will just give you a sore back. Imagine you have a rubber boot full of water. Elevate the foot so the water goes out the top of the boot. Pillow or a rolled up towel at the small of the back, right above the hips, will be helpful.

Acute stuff is generally RICE. Rest, Ice, Compression, Elevation.

What happens is the Talus is driven down through the Calcaneus. This beautiful illustration by Dr Netter even shows the pin to manipulate the fragment trick. You correct the position and throw a plate on the lateral side. The prone with the bent leg is to release the pull of the Achilles and make it easier to move the piece. There is a nerve runs above where the plate will be that can get irritated. I like the maxillofacial sets, they have this little cloverleaf plate that is truly the cat's ass for screwing together a heel.

Calcaneus is a very vascular bone, so it generally heals well. You can actually use it as a donor site for bone grafts.

If she smokes, she needs to stop like yesterday. Smoking is very bad for bone healing, healing in general really. The bad for your lungs is just the obvious thing.

[Don Ro]

What a forum!
Amazing assistance here...in so many areas of life.

[dewolf]

Thanks Toby. I really appreciate your time.

Cheers

[dewolf]

A picture of the break / breaks. Broken in multiple places.

[Tobra]

Yeah, that is a surgical situation, at least a half dozen pieces. I bet the coronal sections on the CT are interesting. She is likely to have arthritis due to the involvement of the joint surface. When it is healed, probably will want orthotics with a flat heel post on that side to limit the amount of motion when walking.


You never want to have anything interesting on your CT scan

[flatbutt]

Originally Posted by dewolf

A picture of the break / breaks. Broken in multiple places.

FAAAAAACKIN' OUCH! Heal well Missus. Time to spoil the Lady a bit.

[recycled sixtie]

That looks painful.

[dewolf]

Originally Posted by Tobra

Yeah, that is a surgical situation, at least a half dozen pieces. I bet the coronal sections on the CT are interesting. She is likely to have arthritis due to the involvement of the joint surface. When it is healed, probably will want orthotics with a flat heel post on that side to limit the amount of motion when walking.


You never want to have anything interesting on your CT scan

The Dr said today that they will need to wait a week for some of the swelling to subside and then they will re-asses as to whether surgery will be required. What's your opinion?

[Tobra]

It s not displaced too badly, but with the joint involvement and comminuted fracture I would be leaning toward fixing it. This is actually a subject that is fairly hotly debated, whether or not to do surgery on calcaneal fractures.

[dewolf]

Ok. Thanks again. I really appreciate your time.