Severe trauma of the right hind and midfoot...?

Foot care
1

Hi, i could really do with your expertise in this. I have questions about my foot and my care after i fell backwards down the emergency exit on a coach on Tuesday and my full body weight was thrown onto my right foot. As a result, in 4 days i have had a back slab, a boot and now a rather funky red removable cast along with crutches.

The hospital report says: The neck of the calceneus is shattered with intra articular fracture extending into the calcaneus cuboid joint. There is also shattered talar sustentaculum also involving the joint surface here. There are two small avulsion fracture of the cuboid, one small in the calcaneobuboid joint inferiorly and laterally and one in the groove of the peroneus longus muscle likely due to the tear of the long plantar ligament of a part thereof.

There is a further and also multi fragment fracture of the inferior and lateral talus from the sulcus into the posterior talar articular facet and again this involves the hindfoot joint here. There are tiny bony fragments around the posterior hindfoot joint.

Conclusion: severe trauma of the right hind and midfoot.

I don't know where to start with this, i guess the biggest problem is the pain, the swelling and the bruising - which is extensive - is this usual?

Should i be PRICEing it? I was told that i could remove the fibreglass cast when relaxing but to keep it elevated. When moving around (hopping) i have to wear it.

I was told at the physio appt that i will never regain full use of my foot as it is basically smashed up, but may with a lot of physio and hard work be able to walk on it - but not move it from side to side (i'm thinking about driving in the future).

I would bow (if i could, lol) to your extensive experience in this matter and any help would be greatly appreciated, thank you. x

2

Hello -     Well,  your injury sounds positively horrendous and frankly I don't understand most of what you've said but ....   I would say to you - follow the advice of your Physio.   Elevate and ice your foot as much as you possibly can and don't consider putting it to the ground until you're told categorically that you can !

This injury sounds quite major but the human body has proved to me to be highly dextorous in re-building itself.  Follow the Physio exercises and do them as many times a day as you're told and for as long as you're told.

I'm sure with effort on your part you will walk and you will drive again but it will take time.  I wish you the very best of luck.  

3

Hi my ankle was shattered in a car accident 6 years ago I do drive even though I don't walk that good so don't worry about that. It will never be the same. I hardly have any movement in my ankle and it's my driving foot the pain and swelling has got worse and now I will be having a 6th surgery in 3 weeks total ankle replacement everyone is different but like I said my ankle doesn't move that much but I drive just fine you do adjust to the limitations good luck

4

I love your nickname, Chocolatecake!

I understand what you have written..but I ask, do you really want to understand all of this minute detail? It's not you could bow to me...chuckle

The good news is, you did not fracture your toes. Toes are important because toes allow us to balance on our feet.

Plantar ligament runs from the heel to the toes and gives the foot the arch.

I happen to have lost my ankle years, okay, maybe decades ago. That means I can not point my toes to depress the gas pedal. So, over time I have developed a hyper ability to move my foot from side to side. I use this side to side and my knee movement to compensate for the loss of my ankle.

With patience, exercises, and in time, you will also learn to compensate for the loss of the side to side movement by becoming more dependent upon the ankle toe pointing in combination with the knee.

I also want to encourage you...for a year my right ankle had to heal.. I drove using my left foot. To this day, I can drive with either foot. I simply went to an empty grocery store lot at night and practised.

Walking...in time, why not? You may need to wear supportive shoes, perhaps with gel insoles ..I encourage you to never give uo and to not push too hard too fast.

Yes, basically you crushed your foot. The tissues , the muscles, everything is going to take time proportional to the injury. I suggest you invest in a nifty knee scooter. Back in the day, I used a wee garden chair turned around backwards...yup, out to the cat, off to work...me and my chair...and I didn't have wheels...

I have survived extreme bone issues, injuries, diseases...because I wanted to survive them...because I took the time to figure out how I could do what I used to do, just differently.

And another secret....some universities enjoy the challenge of designing and making special implants.

Laughter is a fabulous medicine, I like your sense of humor.

kind regards

judith

5

Thanks so much for your positive replies Pauline, Debi and Judith.

Debi, it must be about now that you're having your total ankle replacement? The very best of luck with that. Please let us know how you get on.

You are all very brave and i thank you for your replies and encouragement. You have obviously been in this predicament too Pauline.

I have fallen twice on my foot since the accident (once at university as my wet crutches touched the shiny floor in the disabled access), both resulting in major pain. 4 days after each i had an x-ray to check the shattered pieces haven't moved away from the bones and both luckily were ok.

However, i have since moved my foot very slightly when out of the cast and now in a lot of pain. I'm such an idiot. Also, i have found a lump under a yellow bruise (which has been there for getting on a month) on my tibia. Could it be a fracture? It is the right distance away from my foot from the depth of the stairs i fell down.

My ortho dept know me by name by now, it's getting really silly. Should i go back again for an x-ray on my shin or just mention this at my next appt in early January?

My leg has already started wasting away with the skin at the back of the shin looking not unlike a massive bingo wing!

I am taking vitamins to help with bone strength, but obviously this will take time to work.

It gives me hope that i could perhaps learn to drive with my other foot though as you have done Judith. And one day, i will bow to you, lol!!