Question
I fractured my left calcaneus end of August '06. I had surgery three weeks later - plate and 11 screws. The incision became infected and I had surgery to debride the wound a month later, followed by antibiotics and a wound vac for 8 weeks. I then had to have the hardware removed because the wound would not heal. Cultures done during HW removal were positive for staph and another bacteria, doctors didn't seem to agree on whether it was just in the wound or in the bone - 14 more weeks of antibiotics.

I am now 10 months post injury. I am weight bearing with a limp due to pain and stiffness in the foot. The wound seems to be closed, although I still have slight drainage where the incision turned the corner from foot to ankle. I was referred to a pain management specialist a couple months ago for chronic burning pain along the outside of my foot, around the wound area and am on a time release narcotic pain med. I have now developed burning pain on the bottom of my heel as well, mostly when at rest, which sometimes radiates upward into my ankle, and I still have swelling in my ankle and my rear foot. Should I be looking for a diagnosis for this ongoing pain (ortho surgeon and pain management doc say nerve damage) or should I be expecting this much pain as this stage in my recovery? One thing I've definitely learned - calcaneal fractures are tough injuries!


Answer
Hi Colleen,

I would say that this pain is not normal.

The infection may still be a concern.  Have you had an MRI with contrast recently or a CT scan.  Did anyone ever confirm a bone infection?  That is an avenue that needs to be further explored.

Nerve pain is common after a heel injury, not only due to the injury but also the surgery and fixation devices.  You likely have a nerve entrapment and there are excellent treatments.  I often perform Cryosurgery for this type of pain with excellent success.  See my Cryosurgery website below.

Have you been through physical therapy?  That is a must after this type of injury.

Be careful being pumped full of narcotics as a solution.

I would consider some other opinions including a Podiatrist and especially one that performs Cryosurgery.  What metro area are you in?  I will try to help you find someone.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com

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