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.