UKC

I'm after a bit of advice please and hopefully there'll be someone on UKC who can help.

In 2009 I had a minor leader fall which resulted in a very badly displaced calcanial fracture. This was treated with an open reduction and internal fixation with 5 plates and 9 pins. I subsequently developed post-op compartment syndrome. Since then, a vicious circle of initial immobility, an extremely slow recovery (I'm still limping badly 20 months later) and an inability to walk far has, perhaps inevitably, given rise to ankle tendon problems.

I've finally been diagnosed with acute tenosynovitis of the ankle tendons. The affected tendons are the two peroneal tendons that lie behind the outer ankle bone (the lateral malleolus) and the peroneus brevis tendon which connects to a bump on the base of the fifth metatarsal on the outer edge of the foot. The problem is both very painful and doubly debilitating on top of the continuing issues with the heel itself. I've not long been referred back to the consultant surgeon.

So I was just wondering if any other UKCers have suffered anything similar as well as what was the most effective treatment. I'm keen to avoid further surgery if at all possible.

Thanks in advance etc.

Dave

In reply to Dave Williams:

Havn't a clue...

Could you afford to see a physopthrapist or lower limb specialist not through the NHS, if it might improve your treatment and prospects?

Private physos have been great in my experienc,e with ligaments and my tratment on my achilies tendon.

Cheers
Tim

In reply to Dave Williams:

I kind of got lost in the technical names in your post but think it may be similar ish (maybe not!) to a problem I had. I broke a bone on top of my foot and it heald out of place, the tendon running over the top of it was being poked into by the bone, making running and flexing of the foot really painful, the thing that sorted it in the end after poitless NHS physio trips was the top of the bone being shaved off. Left some slight numbness on the inside of my foot where they cut it open, but fixed the original problem!

Dunno if its quite the same or not!

In reply to Dave Williams:

Sorry for terrible spelling typos and general wording, hopefully the gist is clear.

At least it'll bump your thread up a bit...

Tim

In reply to Dave Williams:

Thanks for the comments so far. Anyone else on UKC experienced tenosynovitis of the ankle?

If not then I'm guessing it's a case of boldly limping where no one has limped before ... :¬(

Dave

In reply to Dave Williams:

your consultant might suggest trying steroid injections?
wish i could offer up some useful piece of advice,but my ankle is still trashed from a break 12mths ago,and so far "we've" tried steroid injections....

In reply to Dave Williams:

Hi Dave,

Your problem sounds fairly similar to what im also going through at the moment.

In July of last year i also had a minor leader fall which resulted in a calcanial fracture, however it wasnt that badly displaced.
I didnt have any surgery, and basicaly was told to rest up for 8 weeks.
At first, progress was good and I was beging to walk with in a month, but as the heel was recovering I noticed that the pain down the side of the ankle and down the side of my foot didnt ease up.

6 months later and the pain isnt much better. If I try rolling the foot inwards or outwards, the pain is pretty intense, and as of yet any physical activity is out of the question, I could probably manage a light jog for a couple of minutes but it wouldnt be painless.

I have been back to the doc's, he suggested that it could be tendon or ligament damage, and said that I probably damaged them in the fall and that they would have healed tight as I wasnt using the foot. I was shown how to stretch them and that they should return to normal.
I have been doing as the doc said since xmas, and have not noticed any change, I think the next step for me is back to the doc's and some private physio.

Out of interest, what range of movement causes you the most discomfort?

Sorry I couldn't offer any advice, just thought I would share my experience!

Allan

In reply to Dave Williams:

I competely sympathise with your situation. I'm still limping around with an infexible and swollen ankle ( still using a crutch ) 6 months after open reduction / internal fixation on broken medial malleolus. My experience is very similar to your description. Feels like I've been like this forever. I can't imagine how you must be feeling after 20 months of it.

I'm now waiting for date for 2nd op to shave off some bone growth ( direct result of the accident ), and am really hoping that this improves things.

Best of luck with your recovery. From my own experience, I can't begin to imagine how fed up you must be. Stay positive, what doesn't kill you makes you stronger and all that . . .

In reply to Cantona:
I used to be a fit and very active person but, as you realise, this is all so frustrating. I'm in more pain now than 10 months after the accident. One GP even suggested that I don't try and walk so much as it's so painful and take up chess as a hobby!

It's hard to stay positive, but "what doesn't kill you makes you stronger" is good advice. Best wishes with your recovery too.

In reply to snailonvalium:

And has there been any improvement?

Dave

In reply to vincentvega:



This mirrors my experience. I strapped up my ankle and went climbing for the first time after 10 months and did a few V Diffs. A couple of months later I even followed an E1 and although climbing was painful, at least I could do it and it seemed as if I was making progress. I've had pain from the beginning and I assumed that this would lessen with time, but unfortunately it hasn't; it's actually got worse. The only way to be relatively pain free is to sit around and do nothing. The more walking I do, the worse the pain. I pushed it to the limit, and perhaps beyond, by walking 2-3 miles last December and I was back on crutches for a couple of days.... I can't run at all, not even a few paces and jumping's completley out of the question too, as is walking barefoot.
>
Again, the same experience. Initially, the GP wouldn't accept that I was having ankle problems as a result of the accident and it took three visits to actually get somewhere. Suggested stretching exercises haven't made any difference to me either and my GP now suspects badly inflammed tendons rather than tight ones. Hence the referral back to the ortho consultant.
>
Side-to-side is an absolute killer, but even normal walking is painful. I've also been left with a heel spur as a result of the injury and despite using orthotics that also causes a lot of pain in itself.
>
I'm very sorry to hear about your troubles. If it's any consolation, apparently at least 25% of people who've had a bad calcanial fracture end up with further soft tissue injury problems.

All the best to you with your recovery.

Dave

In reply to Dave Williams:

The only advice I'd offer you is that in my experience a GP generally knows very little about soft tissue damage and recovery. I was once diagnosed with having a foreign body in my elbow joint, for example, when in fact it was classic golfers elbow.

Go and see a good physio (if not already) who not only will be able to furnish you with all those scary sounding names for your tendons and bits but actually give you some exercises to help you recover. Have you tried acupuncture as well? Not had it myself but meant to be good at getting over the pain which leads to immobility.

In reply to Dave Williams:

The NHS is really good for a lot of things, and other people have posted about having better outcomes through doctors and the NHS, but in my experience it's only been through a private physio that i've been able to have the focussed treatment needed to sort out different injuries i've had. I'll stop posting about physios now so I don't become a forum bore.

Have you tried/thought about swimming as a way of staying fittish and not putting on too much weight while being less active?

Cheers
Tim

In reply to Dave Williams:

Yes, it all seems very similar. You have my sympathy as by the sounds of it your having it worse than myself.

All the best with your recovery also.

Allan