|Joined: 27 Jun 2013|
|Read: 0 topics|
|Fractured toe 4 months ago
I'm a 39-year-old healthy male. About four months ago, I had been walking past a brick structure and hit it with my bare foot. The toe alongside my little toe was obviously broken, as it was twisted upward and toward my little toe. I visited a walk-in clinic on that day,[link widoczny dla zalogowanych], where the doctor x-rayed, set, buddy-taped, and x-rayed it again, then gave me the usual 4-6 week diagnosis. She did not say anything about joints being involved, and to the best of my knowledge it was only a broken phalange.
Here' am, four months later,[link widoczny dla zalogowanych], and still on crutches. My whole foot swells up and turns an in-depth reddish purple if I let it rest down for any amount of time, even if I sleep, so I keep my foot elevated above my heart constantly when I'm awake.
Around three(?) weeks before I got the crutches, I hobbled around on my small heel with a cane. Since I've heard of people walking having a broken toe and my doctor merely told me to put on supportive shoes,[link widoczny dla zalogowanych], it seemed ok to do that at that time, but I'm wondering if putting pressure on my heel affected the healing time, as well as made the injury worse.
I've done a lot of research about this,[link widoczny dla zalogowanych], but I'm still stuck with the next questions: Is it totally uncommon for a toe fracture to consider this long to heal but still cause purple swelling from the whole foot? Also, can walking on the heel for some weeks soon after the injury affect the healing duration of a phalange? Could my doctor have missed something in her own diagnosis?
Orthopedic specialists wouldn't take me with no referral, so since I do not have a family doctor, I visited a walk-in clinic yesterday evening. They took full-foot x-rays, said my bones were built with a moth-eaten appearance, provided possible causes including vascular, bone infection, osteoporosis, and cancer,[link widoczny dla zalogowanych], and put in the diagnosis that my first metatarsal was fractured, despite the fact that he said it might be a sesamoid bone he was seeing about the x-ray. They called ortho first thing this morning to schedule an appointment, then called me back and said I needed to visit the ER instead, because ortho couldn't perform all of the tests I needed.
The ER doctor didn't understand why I was sent there rather than ortho (I suspect it having connected with me lacking insurance?). They took my blood pressure, my temperature and drew blood, I showed him the x-rays from yesterday and the ones from 4 months ago, answered a couple of questions as they pushed in a variety of places, then your ER doctor said he saw a memory foam specialist walking around and took the x-rays to exhibit him.
Before Time passes further, two of the places I feel pain are between my 1st and 2nd toes and my heel, but only when considerable pressure is applied.
After he returned from talking to the ortho specialist, he said he was confident it had been reflex sympathetic dystrophy and that the specialist agreed. Next he said the specialist didn't visit a problem with my bones, so I guess this means both teams of x-rays were underdeveloped, because the ones from 4 months ago appeared to have this same "moth-eaten" appearance after i compared both sets.
When the blood test came back, there is no sign of infection. However, I'm not sure when they were only checking for bone infection, or if soft tissue infection would display in the test they ran.
The ER sent me home having a prescription for Anaprox,[link widoczny dla zalogowanych], told me to follow along with track of a doctor from last night (who had me quite worried wonderful his possibilities), and said I might need physical therapy along with a neurologist.
Returning home and reading up on it online,[link widoczny dla zalogowanych], I don't trust the ER doc's diagnosis. My foot doesn't sweat, nor do I feel pain unless there is pressure applied, and I haven't felt the burning sensation. My condition has not progressed in all this time around. It's merely stayed exactly the same, except for the fact that I used to feel pain in the area of my primary fracture after i moved it, until just a couple weeks ago. I'm wondering if the ER doctor couldn't know enough about reflex sympathetic dystrophy or didn't pay attention to my answers, and maybe was too suggestive when he spoke with the orthopedic specialist. Unfortunately, I didn't witness that conversation to be aware what was said.
Also, you have the issue of the clinic doctor's diagnosis of a fractured 1st metatarsal,[link widoczny dla zalogowanych], which might be a sesamoid bone he was seeing (the ER doc said hello would be a sesamoid). I do feel pain there when pressure is applied, however i can't conceive of any possible way I possibly could have fractured anything on the bottom. Can it be my flexor hallucis longus tendon that hurts there when it is pressed,[link widoczny dla zalogowanych], and what about my heel?
Sorry for asking so many questions, and thanks again for your help so far.
Yesterday I tried standing,[link widoczny dla zalogowanych],[link widoczny dla zalogowanych], gradually applying pressure to the injured foot until there is equal pressure on each foot, and felt intense pain during my ankle or heel, I'm not sure which. Also, after i visit advance on my small injured foot,[link widoczny dla zalogowanych], Personally i think similar pain in my great toe joint where my toe connects to my foot. I'm able to move my ankle and toe in a direction also it doesn't hurt; but the more pressure I put on either area, the greater it hurts, being intense if I put enough pressure onto it just to walk.
Today,[link widoczny dla zalogowanych], my knee hurts if I lift my knee toward my chest from a sitting position. I just noticed this symptom today, and so i figure it has something to do with standing yesterday. My ankle and toe joint have the same as yesterday, moving feels ok, but applying pressure hurts.
Remember, I hobbled on a cane and my heel for some weeks after my toe fracture; next, I used crutches without applying any pressure whatsoever on my small injured left foot or my left leg for the rest of these 4+ months, keeping it elevated constantly everything time.
I truly need to see a professional to properly diagnose my problem(s),[link widoczny dla zalogowanych], but the orthopedic specialist wouldn't take me due to insufficient insurance when my doctor tried to set a scheduled appointment. So, I'm tied to looking to get whatever free advice I can get for the time being, in hopes that I can get medicaid after i apply in a few days.
I additionally attempted to take pictures of my x-rays having a cheap camera,[link widoczny dla zalogowanych], which I'm certain you realize could be a daunting task. The quality isn't exceptional, but I'm posting them just in case it helps for these post. I kept different shots of every one, simply because they show more or less details in different areas.
For other people who could find this information useful,[link widoczny dla zalogowanych], here's what happened.
After breaking my toe, I hobbled around on my small heel with a cane for a few weeks, as mentioned during my first post. This caused unnatural technique injured foot and it started to cause pain in my heel along with other places of my foot that weren't broken,[link widoczny dla zalogowanych], and so i switched to presenting crutches with my injured foot off the ground, and continued using crutches by doing this for around four more months, not while using injured foot at all, since the pain never went away. The toe itself, however,[link widoczny dla zalogowanych], was fully healed, albeit a little crooked because I didn't go back for that initial one-week followup after getting the fracture reduced (set) and my toe buddy-taped.
The pain in weird places ended up being Complex Regional Pain Syndrome (CRPS), otherwise known as Reflex Sympathetic Dystrophy (RSD). This can be a condition of the nervous system that may occasionally occur after a relatively minor injury, usually once the injured limb can be used unnaturally as a result of that injury. Mistake #1 was using the cane improperly and keeping my toes off the floor after i hobbled around on my small heel.
The moth-eaten appearance. remember, this is after four months or so of not walking about the foot whatsoever,[link widoczny dla zalogowanych],[link widoczny dla zalogowanych], suspending it in the air while I walked on one foot and two crutches during that whole time. You heard right, bone atrophy. It was porous since it hadn't been utilized in over 4 months,[link widoczny dla zalogowanych], not due to some disease. That was mistake #2, babying it for all those months after i must have been using it, at least a little bit, despite the pain.
My orthopaedic specialist explained all of this to me after we spent Three hours in her own office last October, looking at my foot and the x-rays, going over my medical history and physical lifestyle, and developing a detailed timeline of my condition over the previous 4 and a half months. She was very thorough and incredibly straight-forward,[link widoczny dla zalogowanych], and that i truly appreciate everything she has accomplished for me. I haven't been back for a few months, but have an appointment for a followup next weekend.
I still have some pain during my foot in the RSD, but I'm walking onto it normally, and luckily it's not nearly as severe as many of the cases I've read about. However for everyone individuals who're looking over this after fracturing a toe, ankle,[link widoczny dla zalogowanych], or whatever, whether it's too painful to walk onto it, it's easier to stay off of it for any week or two until you can flex it normally while walking, than to end up with a possible duration of RSD.
Don't stay from it too long or it will atrophy from non-use. You can regain bone mass with physical rehabilitation afterward, but the more your bones atrophy, the longer it takes to reverse it, and the more you risk another fracture in the thin bones as long as you're attempting to build them up again (which luckily didn't happen to me). Do ask your doctor how to use a cane properly, and follow those instructions. It ought to be held opposite the injured foot, not on exactly the same side as the injury, and that i repeat,[link widoczny dla zalogowanych],[link widoczny dla zalogowanych], the movement of the foot needs to be natural, if you are not putting your full weight onto it.
Should i be wrong in any detail here, I'm certain a doctor will correct me. However, I speak from what my orthopaedic specialist has explained after thorough examination, as well as from my own experience.
Of course, pain in which you don't expect it's not necessarily CRPS/RSD, and you should visit a qualified specialist to make that diagnosis. But I hope this article help prevent another person from getting it, because I've read some problem reports from people whose condition is far more severe than mine, even when the initial injury was no worse.