How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Thomas, MD Your Own Question

Dr. Thomas, MD
Dr. Thomas, MD, Board Certified MD
Category: Neurology
Satisfied Customers: 63757
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
24257177
Type Your Neurology Question Here...
Dr. Thomas, MD is online now

I suffered a severe crush type injury to my left foot in a

Customer Question

I suffered a severe crush type injury to my left foot in a motorcycle accident in 2008. The medial aspect of my left foot was forced into the gear shift lever which penertrated my motorcycle boot and went into my foot causing a deep tear type injury. I suffered avulsion of the tibialis posterior tendon. I had surgery to reattach the tendon and repair the nerves and vessels. I had a skin graft to cover the wound. I also suffered fractured metatarsals.
Following a period of recovery I was still suffering from severe pain in the foot.
I had previously fractured metatarsals in the same foot in 1979. X-rays showed that I was suffering from degenerative arthritis in the joints in the forefoot. Two orthopaedic surgeons
believed the pain was due to the arthritic changes in my foot, one in particular believed that the main cause of the pain was due to the fractures sustained in 1979 and was not attributable to the injury sustained in 2008.
I have numerous pain relieving injections and it was advised that the best course of action would be to have a mid foot fusion. I had this in May 2011.
Following this procedure I was still suffering from severe pain in my foot. This was a burning stabbing type pain around the wound site that would increase and travel down towards my toes over the course of the day, more recently the pain has spread to my heel and lower ankle. I have evidence of a collapsed arch and am suffering from a flat foot. Although the fusion procedure is viewed a success the level of pain I suffer from has not improved. I have had pain relief injections around the wound site aat the pain management clinic. At this clinic I have also had electrical pulse treatment and most recently treatment was RF and PRF left foot tibial nerve and scar.
I am still in constant pain which I believe is due to the tendon and nerve damage sustained in the accident of 2008 and not related to the fractured metatarsals. I have research the type of pain I have and I am able to match the symptoms to pain caused by flat foot deformity and tendon and nerve related issues. I am due to see a consultant neurologist and I wanted to know if they would be able to establish the reasons for the pain and what I should be asking. I have seen that issues with flat foot deformity are due to the tendon damage and could result in a triple arthrodesis, is this or is there any other procedures I should be asking about please?
Submitted: 3 years ago.
Category: Neurology
Expert:  Dr. Thomas, MD replied 3 years ago.
Hello from JA
Thanks for the very interesting question.

You should be asking about orthotics
Have you been measured for these?

The arch problem can be compensated by customer insoles to all shows.

You should also be asking to see a non-invasive orthopedist who will look at other structural components of this pain, such as pelvic dysfunction, lower spine problems, all of which are commonly overlooked in this situation, and will give you therapy accordingly.

Your next steps should be this type of doctor and a podiatrist, virtually simultaneously.

OK. If you have further questions or details, use reply to expert.
Otherwise please choose a positive rating [smiley face or accept]. But, still come back if you need to…think of something later, etc. Bonuses are appreciated.
Customer: replied 3 years ago.

Thank you for your reply. An orthopaedic consultant has written in his report that all my problems are related to the previous metatarsal fractures sustained in the accident in 1979. In the accident in 2008 I sustained further metatarsal fractures and a tear injury to the foot which torn the tib tendon and damaged the nerve. I believe that it is this injury which is causing me the severe foot pain I currently suffer with. I am due to see a consultant neurologist in the near future and wanted to know if he would be able to identify if the pain is related to the tendon and nerve damage sustained in 2008.


I want to know if I could suffer with ongoing pain purely related to the tendon and nerve damage please?


Expert:  Dr. Thomas, MD replied 3 years ago.
Nerve damage yes.

Tenodon injury, yes if there is a deformaty that needs the orthotics, or physical therapy or further repair.

Nerver damage in some cases can take a very long time to recover.

Somtimes it does not.


With this type of pain, complex regional pain syndrome should also be considered.

The neurologist can do testing to see if you have nerve conduction problems [EMG/NCS]

OK. If you have further questions or details, use reply to expert.

Otherwise please choose a positive rating [smiley face or accept]. But, still come back if you need to…think of something later, etc. Bonuses are appreciated.


Customer: replied 3 years ago.

Thank you for your reply.


My post tib tendon was torn on the underside of the foot. This was reattached via surgery. I understand that once this tendon has been damaged it can also cause pain. I have also read that damage to this tendon can result in the collapse of the arch in the foot (flat foot) which then increase problems and pain in the underside and hindfoot. Can you confirm if this is the case please?

Expert:  Dr. Thomas, MD replied 3 years ago.
In fact if it was repaired it should not be causing this problem, particularly if the correct therapy were done.

An MRI can show if this is the case, but I would say no, this is not necessarily the case at all.

please choose a positive rating [smiley face or accept]. But, still come back if you need to…think of something later, etc. Bonuses are appreciated.

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • Dr. F

    Dr. F

    Board Certified MD

    Satisfied Customers:

    266
    Neurosurgeon with more than 20 years experience in practice and teaching.
< Last | Next >
  • http://ww2.justanswer.com/uploads/BrainLifeDoc/2010-10-04_004701_AMF_2008_2_pix.jpg Dr. F's Avatar

    Dr. F

    Board Certified MD

    Satisfied Customers:

    266
    Neurosurgeon with more than 20 years experience in practice and teaching.
  • http://ww2.justanswer.com/uploads/TO/TOHfan1/2012-3-3_11610_strokedoc.64x64.jpg Stroke Doc's Avatar

    Stroke Doc

    Board Certified Physician

    Satisfied Customers:

    41
    I am board-certified in Neurology and the subspecialty Vascular Neurology.
  • http://ww2.justanswer.com/uploads/PR/pradocs/2012-7-23_23649_201272323220JApicture105x113.64x64.jpg Dr. Bob's Avatar

    Dr. Bob

    Neurologist (MD)

    Satisfied Customers:

    1493
    Neurology & Int Medicine (US Trained): 20 yrs experience
  • http://ww2.justanswer.com/uploads/HE/healthydoc/2011-7-22_193154_LevGrinman2.64x64.jpg healthydoc's Avatar

    healthydoc

    Board Certified Physician

    Satisfied Customers:

    325
    Board Certified U.S. Neurologist
  • /img/opt/shirt.png RH's Avatar

    RH

    Board Certified Neurologist

    Satisfied Customers:

    1944
    Expert in various areas of Neurology
  • /img/opt/shirt.png Brainmaster's Avatar

    Brainmaster

    Board Certified MD

    Satisfied Customers:

    58
    ABPN certified. 6 years of outpatient general neurology practice experience. No malpractice cases
  • /img/opt/shirt.png braindr11's Avatar

    braindr11

    Board Certified Physician

    Satisfied Customers:

    43
    Neurologist with outstanding expertise