Houston Methodist. Leading Medicine

Foot FAQ

Question:

I developed a painful problem called complex regional pain syndrome (CRPS) after braking my foot in three places. The heel fracture never knitted back together properly. I can't help but wonder if surgery to correct the fracture would help. Can't they rebreak the bone and line it up properly? It seems like I've heard that kind of treatment is done for some people.

Answer:

Complex regional pain syndrome or CRPS is a very painful disorder that affects people after major trauma such as you have experienced with multiple fractures and especially a fracture that hasn't healed quite right. Some people do develop this condition after a seemingly minor injury. People with complex regional pain syndrome (CRPS) often experience intense pain, swelling and skin changes (color, texture, hair growth, temperature). The net result is a loss of motion and function along with reduced quality of life. The problem is not understood very well. Doctors don't know what causes it or why it happens. That makes CRPS a difficult condition to treat effectively. Although rebreaking a bone and resetting it can be used in some circumstances to relieve pain and correct deformity, it's not recommended for patients with malunion and CRPS. The additional surgery is another type of trauma that the already compromised nervous system may not be able to handle. You are more likely to get relief from painful symptoms with antiinflammatory (or other) medications, relaxation techniques, and/or nutritional supplementation. Although experts agree that CRPS cannot be corrected surgically, nerve blocks may be beneficial. There are several different ways to do these blocks. If the procedure works but the painful symptoms come back, a procedure can be done to stop messages Patients with comnplex regional pain syndrome from any cause seem to respond best to conservative (nonoperative) care. Physical therapy is one approach many patients rely on to gain control over their pain and improve (if not restore) function. The therapist will help you find a treatment or combination of treatments that will be most effective for you. Therapy focuses on improving joint motion, strength, and movement patterns needed for daily activities, work, and recreational activities or hobbies. Rahul Banerjee, MD, et al. Management of Calcaneal Malunion. In Journal of the American Academy of Orthopaedic Surgeons. January 2011. Vol. 19. No. 1. Pp. 27-36.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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