David Rees is a 47-year-old who runs his own business in Surrey. He came to the London Foot and Ankle Centre in 2010 following problems related to a serious road traffic accident two years earlier. Mr Rees had a subtalar fusion operation undertaken by Mr Martin Klinke.
Describe your foot problem
I was involved in a very serious car accident in 2008. I had multiple fractures including broken ribs and a punctured lung. I spent 10 days in intensive care and three months in hospital overall. Although I found the immediate emergency care I received was generally good, once I left hospital, it became very patchy to say the least. I had smashed my right calcaneum (or heel) bone and fractured the same bone in my left foot. I was in constant pain, had an open wound and was walking around on the back of a heel bone which was still broken. I canvassed several opinions and did my own internet research and decided I needed to manage my own recovery. It was clear that the London Foot and Ankle Centre was the premier place for specialists in foot and ankle surgery.
Why did you choose subtalar fusion surgery?
Mr Klinke was very informative when he went through all the x-rays and CT images. When I asked him whether anything could be done, he said yes. Immediately, that was a huge horizon lift for me. I had finally found someone who was confident about performing a reconstruction operation. Given the seriousness of my injuries, I knew that I was never going to be 100 per cent. But Mr Klinke was confident that fusion and reconstruction would make a very significant difference in my mobility and eradicate the constant pain. The operation took place in September 2010.
How did you feel straight after surgery?
The first few days after surgery were not too bad; I’d been through much worse after my accident. The pain killers worked very well so there was no significant pain or discomfort. It is important to stick to the dosing schedule. I spent two days in hospital before going home. When I went back into hospital after one week to have my temporary plaster removed, the wound was clean. I had a permanent plastercast fitted, running from my foot to my knee.
Two to four weeks
You need to be well prepared for an operation like this. I had basic things like food supplies and a portable commode in place ready for when I came home. I was given a special boot which could be worn over the plastercast while you have a bath. It kept the plastercast completely dry, so I could relax and enjoy the bath without worrying. Psychologically, that was really important.
Six weeks to three months
By six weeks, I was able to get around on crutches pretty well. But you know the recovery is a long haul and there is a considerable distance to go. I had arranged my business so I could take six month to 12 months off work. Having the operation was an investment in my health and I wanted to do everything I could to work towards an optimum recovery. At four to five months the plaster came off and I was able to cycle for the first time, which felt great.
Three to six months
I got some orthotics, which I wear almost all the time and find very helpful. I also ordered some special crocs from America, which were originally designed for people with foot problems related to diabetes. They have silver soles and provide the heel with greater comfort, but also allow more air to reach the feet. Getting the right, comfortable shoes after foot surgery is difficult. I found I needed a larger size in my right foot due to the swelling. My special diabetic crocs turned out to be the most comfortable option.
Six months and beyond
I was able to go for a very light jog and run with my children. I didn’t push too hard – I know my recovery will take time. I am now ten months post op, but it is likely to be a year or 18 months to full recovery. I have no pain whatsoever. I can walk over bumpy surfaces such as pebbles on a beach. I think the fear many people have about fusion is that after surgery, you won’t be able to move your foot. It’s surprising how much flexibility you do have and that enables you to walk over the most challenging surfaces, such as pebbles.
What would your advice be to anyone considering subtalar fusion surgery?
I would say, first of all, do you own research. Canvass opinion and the internet is a wonderful tool to learn about the different options and where you could go. You need to know that your surgeon is an experienced foot and ankle specialist. I was very surprised at the variety of advice and support I had and felt very relieved to finally meet Mr Klinke. If you do decide to have subtalar fusion surgery, it is a major procedure and recovery will take a long time. You need to have a positive frame of mind to get through it. For me, fusion was undoubtedly the right option – I’m delighted with the results. I am free from daily pain and I can feel my muscles coming back and starting to flex. The operation has been a great success.
