Navicular fracture shattered with bone graft
(Fort Lauderdale, FL, USA)
Im 3 1/2 months post-op. This thing (left foot) is still causing me nightmares. Cramping at night. Walking on it weight-bearing is tolerable but seems like Im stepping on a nail on the planter side of my foot parallel to the incision on the dorsal side of my foot. It brings me to tears. My orthopedist has cleared me to return to work now which Im still in pain, unsteady and have fallen because of lack of strength in my left foot. (which is not cool since I had a monteggia Variant Fracture (3fractures actually, 2/ulna and 1/radius head in Y shape) at the same time I injured my left foot falling 8ft when a ladder collapsed beneath me.
Anyway, is this pain normal? The feeling Im stepping on a nail with every step?RESPONSE
At first blush it would appear to me that the amount of pain you describe is not normal 3 1/2 months post op.
This might be easier for me to wrap my head around if I could see some x-rays but I will have to make do with the information you are supplying me. The enclosed picture reveals perhaps a little more swelling in the left foot, but other than that, it is of little help.
Suffice it to say that every one has a different pain threshold and furthermore every one heals at a different rate. Should you be completely healed at three and half months? Probably not. But, what I would have hoped you would have said is that you still have some degree of discomfort, but overall, the foot is much better.
Furthermore you are seeing improvement every week. If this is the case, then you can assume things will continue to get better and your doctor is clearing you with the understanding that you are "well on your way to being healed".
Having said that, if you still feel like you are
walking on a nail all the time and it is painful enough to bring you to tears then something is wrong, or at the very least you are healing slowly and will require more time. I have no way of knowing without seeing an x-ray. Stated another way, if your improvement has leveled off and you are not seeing further improvement then you need to be concerned.
If you have told your surgeon how the foot feels to walk on, then I am at a loss as to how he feels you are ready to be discharged.
I have no idea who your surgeon is, nor do I really care, but many times a surgeon will look at the final x-ray and if every thing appears "normal" then you are discharged, without taking into account whether or not there is any excessive pain.
I would assume at your last visit you told the doctor about the feeling of walking on a nail and would be curious as to what his response was.
As I see it, you have two choices. You can go back to your surgeon and have a candid conversation about the amount of pain you are having and let him reassess whether or not you are ready to go back to work, or perhaps more importantly whether or not there is some issue with your surgery that needs to be further addressed.
Of course, the type of work you do also comes into play. If you have a job where you are seated all day then returning to work should be no big deal, but if your job requires you to be on your feet all day, that could be a problem.
If you get no satisfaction in your answer, then the smart move here would be to seek a second opinion from another doctor in your area who can view your x-rays and actually examine you.
Marc Mitnick DPMDISCLAIMER