Lisfranc/mid Foot Damage - Ligament - Misdiagnosed - Fusion?

Two years ago I fell onto my big toe, and heard a loud SNAP. The arch of my foot had collapsed immediately. There was a bruise on the top and bottom of my foot over the lisfranc joint. I couldn't bear weight for 1-2 weeks, can't remember exactly.

I had x-rays that showed nothing. I still don't know exactly what I did. The arch has collapsed and my foot aches all the time. I was told to have physiotherapy and wear an orthotic.

I fear I either tore slightly or completely the lisfranc ligament. Hopefully I didn't fracture anything. Recently I had a weight-bearing x-ray that showed loss of arch height and exaggerated space in the joint complex, but this was brushed off - I think, because the injury is so old. 

I was told I couldn't have suffered a lisfranc or I'd still be in terrible pain; however, I have read online similar misdiagnosed subtle injuries like mine that only become painful YEARS later, by then, with more damage done.

This is how it is: I can move the cuneiform (?) quite easily with my fingers, whereas I can't with the other foot. It feels loose, but not painful when I do this. It's slightly painful if I go on the tip of my toes, just feels strained. It's also much more prominent than my other foot. The arch sags from this point, as it did when I first heard the snap.

Has anyone else had an old ligament tear, gotten by with orthotics, and had no significant problems? 

I worry about arthritis setting in. Should I pursue and find out EXACTLY what I did? Or should I get by with the orthotic and if/when arthritis sets in, then have a fusion? Ignorance being bliss?

I know whatever I did, at this stage, the only thing left is fusion. I'm not sure whether this is something I should be doing sooner rather than later.

Could someone shed light on fusion? Especially if they had it young (I'm 20) and how it holds up long term etc.

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Comminuted Calcaneal Fracture With Subtalar Fusion

I thought I would share my story and healing process as I am recovering from a ladder fall from about 8-9' up onto concrete in November, 2014. I welcome any and all advice and hope my story and (hopefully) regular updates on my own progress will help others who may go through this same event.

On Nov. 30, 2014, I fell from a 10' ladder as I was trying to hang a Christmas wreath above my front door like I had done for the last 14 years! I tried doing this without my wife spotting me on the ladder and, when I reached to try to hang one of the wreath wires, I lost the center of gravity on the ladder and had no option that didn't involve me likely killing myself other than jumping off the ladder onto the concrete patio below. I was wearing running shoes and, after landing and gathering myself after a couple of minutes from the shock and immediate pain, thought I might have ruptured my right Achilles tendon. After inspecting the back of my heel, though, it was apparent that the tendon was still intact and I then realized that I likely had broken at least my heel bond (Calcaneus) as I could not tolerate even the lightest touch on any part of the bottom of my injured foot. I was home alone and had to hop into the house to retrieve my cell phone, spraining my good left knee in the process.

A trip to the emergency room and an x-ray later, it was confirmed that I had suffered a Calcaneal fracture.

I was 57 years old at the time of my fall, just two weeks shy of my 58th birthday. I had gotten in pretty good shape over the course of the year, having gotten back to a regular gym routine and running with frequency, as well. I am 5'11" and weighed around 195 lbs. at the time of my injury. My ideal weight is likely around 180-185, so I was at least 10-15 lbs overweight at that time.

After finding the best qualified orthopedic specialist in the area (he is a part of the top ortho group in the area and is the only surgeon in their 12-15 member practice group that does NOTHING BUT foot and ankle surgery. Lesson #1 learned: Find a surgeon whose practice is all but focused solely on the foot!! I have complete confidence that I could not have found a better doctor to do this surgery in my area (Dallas-Fort Worth, Texas).

I had a CT scan performed a week after the injury and after some of the swelling had subsided - it showed a Comminuted Fracture (essentially shattered into three large pieces and many smaller). My surgeon could not have stressed enough how important it was to keep my foot elevated above my heart in the several days prior to the surgery and told me that, had I been much older, surgery might not have been advised due to deteriorating circulation issues in feet for patients over 60 years old. This was, in fact, his major concern throughout; namely, that adequate blood supply would allow for healing of the surgical wound required for the surgery.

I had my surgery on December 11, 2014, and stayed overnight in the hospital. My surgery involved an open lateral incision on the outside of my heel with the insertion and fixation of a titanium plate and eight screws that extend nearly all the way across the width of my reassembled heel. Because my subtalar joint was also severely damaged in the fall, my surgeon had advised me that a fusion of the Talus with the Calcaneus was likely after he visually surveyed the cartilage and he did, indeed, also proceed with this fusion procedure which resulted in about a 5" long screw being inserted from the very back of my heel near the base and extending into the Talus bone above. I was told I will lose most of my lateral flexibility in my foot but should eventually recover most of my front-to-back foot flexibility.

I had been given a nerve block after surgery and felt no discomfort at all until the nerve block wore off the next evening. When that block wears off, it does so with a vengeance! I took Oxycontin for the next couple of days, then switched to Hydrocodone for pain and Naproxen Sodium for swelling thereafter. I got off the HC as quickly as I could (3-4 days later) and still take naproxen on a regular basis to manage the lesser pain and swelling.

I will follow up in the next few days with my thoughts on my recovery progress and outlook since then - I know this post may have some overkill from a factual standpoint but I wanted to include information that I personally would have liked to have known in reading other threads.

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Big Toe - Fusion Of Bone OR Replacement Of Joint?

Saw an orthopaedic consultant yesterday who confirmed, after an xray, that the osteoarthritis in the big toe joint is getting worse. He suggested two different types of surgery: a fusion of the bone or a replacement of the joint. I am leaning towards the latter although I don't know much about it and the consultant admitted the success rate isn't great! Has anyone had it done or know more about it?

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Dislocation Of Shoulder Joint With Fracture In Humerus

last month i met with an accident. Then i undergone the k-wire surjury.after the surjery the docter Mr.vedamoorthy from tenkasi,who done the surgery he teken the x-ray.The x-ray is like this.Now 38 days gone.my dislocated hemerrus bone is like this. Now what to do?. 

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Back Issues :: Single Facet Joint Removal And Fusion

My L4-L5 synovial cyst that I had removed two months ago has recurred again - this was the 2nd removal, so I've now grown 3 synovial cysts from the same dysfunctional facet joint.

One surgeon has recommended removing the bad facet joint which is causing the cysts and doing a microscopic fusion just at that level on that one side. I have no instability and no back pain issues elsewhere, so this is sounding like my best option, and not a very extensive surgery. I was wondering if anyone has had a fusion with a facet joint removal and how it worked out.

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Hardware Removal? Lisfranc With A Broken 1st And 2nd Metatarsal

Tomorrow makes a week since my Lisfranc injury. Unfortunately I do not have a glorified story of how I broke it but basically got light headed & dizzy as I was walking up a step into my home, my legs gave out and all of my weight dropped on my foot that was on the step. As soon as it happened I knew something in my foot wasn't happy so off to the ER we went. ER was a total nightmare and knowing what I do now I would have just been better off waiting to go to the foot Dr. Went to the foot Dr and he said I have a Lisfranc injury and recommended that I see a specialist so I went. He informed me that I had broken my 1st & 2nd metatarsals and torn the ligaments. He recommended surgery to properly correct and said that I would need two screws to put it back in place. I am scheduled for surgery in two days!

What should I expect? Will it truly be a 2-4 month process before I can run and actively get back into the gym again? Will the pain after the surgery be far worse than the pain since the break? Did you eventually have your hardware removed and if so, why?

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Heel Pain :: MRI - Minimal Joint Effusion Is Seen Tibiotalar Joint

Hi Experts,

I have been into long distance running since long. Lately I started suffering from severe heel pain for which I had an MRI which says:

1. Minimal joint effusion is seen tibiotalar joint anterior and posterior recesses.

2. Soft tissue edema is seen in kager fat and anterior of ankle.

3. Minimal insignificant fluid in subtalar joint and intertarsal joints.

Its been two months I have not been running and I am feeling equal pain all the time. Pressing heel by thumb gives me worst pain. I can't move barefoot anymore. Orthotics insoles provide relief.

I have been dipping my legs in ice water and not running since 2 months but no relief at all.

I am 31 year old male, 5'11" and 78 kg.

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Temporomandibular Joint :: Total Joint Replacement - What To Expect?

So I have been advised by 2 different oral surgeons I need total joint replacement of both joints.

For those of who have gone through joint replacement, I would really appreciate knowing:

1) what questions I should be asking the surgeons about the surgery, about the outcomes; about post-op care; risks;

2) what your personal exerpience was - just want to know what to expect.

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Fracture Of The Fifth And Second Metatarsal

I posted a few wks ago I fell down a step at work and rolled my ankle, pain was excruciating at the time I went to a&e and x ray was clear, went back after five weeks and xray clear again, I had an Mrs Saturday after 6.5 weeks and it shows a fracture of the fifth and second metatarsal, waiting for mri report to go to a&e, should have it later, worried that I have done further damage, will they cast it now or is it too late

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Lichen Sclerosus :: Reverse Fusion?

When I received my diagnosis a month or so ago, I spent a lot of time reading this forum and learned an overwhelming amount of information. One post that stood out was someone who had managed to somewhat reverse their fusion with a baking soda spray treatment. I can't find that post, or remember what thread it was posted on, and I'm hoping someone can point me in the right direction. If there is anyone else who has managed to reverse their fusion.

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Foot / Ankle :: Fusion Vs Replacemet

My surgeon and I met today to discuss the continuing problems I am having with my left ankle. We started to talk about a fusion and I suggested an ankle replacement. He says I am too young for a replacement. I am 42 and he said they like to only do them on people in their mid-50s or older.
Has anyone had a replacement that is younger than mid-50s? Any recommendations regarding which surgery would be better?

Any help would be greatly appreciated. Just very frustrated with the lack of function and level of pain at this point after 4 surgeries.

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Wrist Fusion - Will Be Able To Ride My Motorcycle?

I am in a few weeks having total wrist fusion (left). Will Still be able to ride my motorcycle after?

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Dihydrocodeine :: Spinal Fusion - Only Possible Cure?

after contracting cervical spondylosis through an industrial accident i have taken many different forms of medication, namely diclofenac, tramadol and co-dydramol, none work, two disc replacements later, c5-c6 c6-c7, still symptoms persist, tramadol are horrendous, sleepless nights itchiness mild vertigo drowsiness, a truly awful drug, diclofenac caused some form of breathing difficulty, although im not an asthma sufferer, i think the only possible cure for this illness is a spinal fusion, my surgeon seems reluctant in doing this as he is trialling new discs, i never wanted to be a guinea pig, i just wanted to be cured, four years later im worse than ever, no work cant drive cant sleep at night, any ideas?

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Hallux Rigidus - Osteotomy Or Fusion For ?

I had a fusion of my big toe on October 28, 2009. As I approach my first anniversary, I am happy with the results. My joint was severely damaged. The surgeon said I had two choices, cheilectomy and fusion. He did not think the cheilectomy would work for me and if it did, it would only likely last a year. I did some research and realized that I was headed for a fusion. I decided on that and I am glad I did.

My recovery has been good. I did have a couple of scares when the radiologist suggested there might be a bone infection. Fortunately, that turned out not to be the case. I suspect he was confusing healing with signs of infection. At any rate, now that it is a year later, I have pretty much no pain. I am walking every day, usually at least a mile or two each morning. Sometimes I walk up to five or seven miles in one walk. My foot is up for the task. I have started curling for the season now, and my foot is great. The last time I curled, my foot was very sore (pre-surgery). It was so nice to curl without pain! Also, with all my walking, I am in better shape than before, so I curled amazingly well. Scary.

There is some misinformation about fusions I'd like to address: Your gait will be altered with a fusion - my gait was altered by the sore foot and limited range of motion from the arthritis. Now my gait is normal, I toe off the big toe again. That means that now my hip feels better. You won't be able to run or be active - fusion is actually recommended for people who wish to remain active. At least if the foot is damaged beyond a certain point. I am more able to run now than I was pre-surgery because I have a stable foot that does not hurt. Surgery is painful - yes, I had about four days of pain that required medication. After that, as long as I had my foot elevated, I was fine. I think bunion surgery is much more painful

Fusion is certainly a drastic procedure that probably should not be considered lightly. At the same time, if it is the right procedure it is fabulous.

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Back - T12-L5 Fusion :: Edema Around Screw

My last back surgery was a T12-L5 fusion to correct scoliosis. I would say it's a failed back surgery because my back is so weak I must use either a cane or walker most of the time. I have constantly had a burning pain in my groin and lower back for which I take oxycodone and use ice to relieve the pain.

Now the question: for more than a year (the surgery was 2 years ago) I have had swelling with fluid around one of the T12 screws. X-rays were done then and again the last of May and both show the screw has backed out somewhat but is still intact. In fact, the more recent x-ray is exactly like the first one, so it seems it isn't moving. My neurosurgeon said he could remove the screw and cut the rod down if I wanted him to. At the time, I said, "No, not yet." That was a couple months ago. However, the edema is getting larger, moving to the right side of my spine and moving lower. It's also getting almost impossible to get a good seating position because of it.

Sorry to be so long about this, but I'm wondering if any of you have had this problem, and if so, what did you do about it? At the moment, I'm facing a total shoulder replacement surgery in 2 weeks, and then possibly eye surgery after that, so I can't do anything soon, it seems. Just trying to see what my options are.

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Neck And Shoulder Pain On The Other Side After A C-5 C-6 Fusion

I have been suffering from nerve pain that ran down my left arm and shoulder and fingers from a bulging disc in the C-5- C-6 so i had been taking oxycodone 10-325 but when we decided to do surgery we cut that down to oxycodone 5/325 since that is what the surgeon would be giving me after surgery so i said okay no problem.  I had surgery  on 2/26 of this year, But after surgery come to find out he dropped me to a hydrocodone 7.5/325 and can't understand why the 7.5 hydro's weren't working to take away the pain. I had been having a lil bit of pain on the right shoulder before surgery, but nothing like what i had been having in the left so the surgeon side well "let's hope this will fix this side too" well it didn't. In fact it made the right side worse, I now feel like i have a hot knife twisting at the base of my neck whenever i turn my neck to the right or left, which in turn  runs down into my shoulder blades and into my right shoulder which makes my shoulder feel like someone it trying to tear my shoulder off at the cuff along with weakness in my right arm which i never had before ..  I have also  started to notice a tingling in my right pinky finger and ring finger.  I have told him over and over about this but all he does is get the X-rays and says the fusion is looking fine. and my primary can't do anything since he told her he would treat my pain for 6 weeks and he is refusing to do anything about the pain what so ever. i am to my wits end and any advice would be welcomed.

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Back Issues :: Clicking After L5 - S1 Spinal Fusion

I am almost 2 years post op from an L5 - S1 spinal fusion. I had three surgeries in 9 months before the fusion. I have never been 100% since. The pain is not as severe or crippling, but there is much that I am unable to do. I cannot stand for more than 20 minutes, cannot walk around for more than 30 minutes and have to alternate sitting with laying down. I take Vicodin 1-2 times each day for the pain. I also have numbness in the left foot from the middle toe to the pinky and around the outside of the foot to the heel. My concern now is that I hear a "clicking" when I get up from sitting or lying down. I live in Minnesota and the winter is brutal! I suffer more with extreme cold and damp weather. Is this something to be concerned with or just another item to learn to accept? Is it possible to have an MRI after a fusion?

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Urinary Incontinence After Laminectomy W/bone Fusion?

After being diagnosed with lumbar spinal stenosis in 1992 and undergoing several other treatment options that were not successful, I had back surgery, a laminectomy w/bone fusion. I then developed urinary incontinence, which is still a problem for me. and also lost my mobility. I am now spending most of the time in a wheelchair, although I am able to use a walker for very limited distance walking. I still suffer from back pain but do get some relief from a prescription pain med. I just wondered if anyone else had developed urinary incontinence after having back surgery?

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Repeated Discectomy And Laminectomy And TLIF Fusion Of L5/S1

Back in 2012 after 2 years of severe sciatica that was treated with painkillers, I finally got an MRI which showed disc herniation at L5/S1, I had a microdiscectomy & the surgeon said it was a difficult procedure as the disc had calcified. I did however have some relief & a huge reduction in pain.

After about a year the pain had increased to the point my mobility was affected & I was referred back to my neuro, he carried out MRI & another micro discectomy & unfortunately this actually left me immediately in more pain.

So I had another MRI which showed again more herniated disc trapping my nerves, this was only 6 weeks after my 2nd op, my surgeon said he could do no more for me but he then referred me onto a colleague for a TLIF fusion of L5/S1.

Which was done, but again no significant improvements so after 12 weeks my neuro sent me for more MRI & CT scans, this showed halo's around my fusion screws, crowding at L5/s1 & a post op collection around the incision site, he prescribed 6 weeks antibiotic course & re-did the scans.

There was no change to the collection & he then decided he would need to operate again in case of infection.

When he operated he found no infection inside but there was 'bugs' in the fluid collection in my back.

He said the fluid was seroma & he was confused as seroma fluid never has bugs in it?

Whilst he was in my back he did yet another discectomy & laminectomy, he said he did not check the fusion itself as it meant disturbing scar tissue.

At this point he said nothing more can be done for me.

This is heartbreaking to me, I'm 39 yrs old, I have a physical job as an electrician & I don't want to be sat about or lose my job.

My pain is still extreme in my right leg & hip, my buttock still feel numb & my calf feels tight & achy.

My last op was only a week ago but after 4 surgeries on one small place, I still feel in excruciating pain & it feels like there is no light at the end of the tunnel, my back around the incision site is still swollen like it was before this surgery & I'm worried the fluid is coming back, the build up of that fluid had caused problems on my left side & had not got any smaller in the 5 months between the surgeries.

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