While the road to recovery can be long and difficult, many people can make a full recovery and return to their previous level of activity. If you have trouble moving your ankle, you can also try using a handheld range of motion device. The primary goals of physical therapy are to reduce pain and swelling, improve range of motion, and help you regain strength and mobility. She eventually returned to her job and is now living life to the fullest. They gave me crutches and said to stay off it for a while. The third thing is what you do to speed up the healing of that fracture after the surgery. Alternate between sides every few seconds, then hold each side for about 30 seconds. If supplied, wear the boot for comfort and use crutches when walking. If your knee pain will not go away and interferes with activity, visit your doctor. Went back to the ER, was told its likely a stress fracture, referred to a CT scan and to stay off it fully- and I listened this time. Yes, you can fully recover from a calcaneus fracture. Keep reading if you want to know more about life after a calcaneus fracture. Should I wait at the ER or go home and try to care for my UPDATE: Both Sons Intubated (2M & 3M). Article Processing Charges Journal Impact Factor Peer Review Process Article Impact Factor. Your doctor or physiotherapist will give you exercises to do while in hospital. Tran et al. In extreme cases it can stop healing altogether. If you have any problems with your feet, talk to your doctor. A physical therapist can help you with these exercises, as well as exercises that improve your foot and ankle strength. Bumps on the bottom of the foot can have a number of causes. The ends of the bones where they touch are covered with articular cartilage, a smooth slippery substance that protects the bones as you bend and straighten your knee. Stress fracture occurs more gradually, over a period of time, due to overuse or repetitive impact/trauma to the bone. Stand with the ball of your foot on a step and your heel hanging off, keeping your leg straight, slowly lower your heel below the step level. But there are always things that you can do to speed up the process. He eventually completed the marathon he had been training for, and he now runs several races each year. When it does occur, however, it can cause pain in the heel or ankle. These devices have a handle that you hold onto while you move your foot up and down or in a circular motion. WebThe Medical Services Advisory Committee (MSAC) is an independent non-statutory committee established by the Australian Government Minister for Health in 1998. It is important to start slowly, though, and gradually increase the weight you are putting on your foot. tendons, and ligaments and takes a longer time to heal. During the course of your rehabilitation, you may need as many as 20 visits with your physical therapist, MD Guidelines notes. . Soft-, firm- and hard-molded arch supports can help prevent the foot from overpronating and relieve pain and fatigue. Keep reading for more information about life after a calcaneus fracture. Fitting shoes can cause pain and irritation, so its important to find a pair that feels good on your foot. One of the most effective ways to promote healing is through muscle strengthening. BraceAbility Sleeping Stretch Boot - Plantar Fasciitis Night Foot Splint Adjustable Achilles Tendonitis Brace for Fascia, Tendon and Calf Stretching, Heel and Bone Spur, Arch Pain Treatment (Medium) CHECK LATEST PRICE. Open fractures have a higher risk of infection in both the wound and the bone. When you recover enough to put weight on your affected foot, your doctor and therapist will ask you to start performing walking exercises, which may require the use of a cane and/or a protective boot. Acute fractures occur when there is direct trauma or impact to the bone such as seen in a vicious football tackle. This conditioncalled adolescent anterior knee paincommonly occurs in many healthy young athletes, especially girls. Published online: May 25, 2022. How does a fracture of the femoral condyle happen? The following exercises can help improve your balance: It is important to talk to your doctor or physical therapist before starting any new exercises, as they can help you modify the exercises to your specific needs and abilities. Here are some tips to help you along the way. Magnetic resonance imaging (MRI) scans. Your surgeon will tell you how long you should use crutches. Recovery can take a long time. Here are some tips to help you along the way. I need to push through the discomfort (within reason)? Other common symptoms include: Adolescent anterior knee pain syndrome does not usually cause swelling around the knee. Start-up pain in the plantar heel area is typical for this. Not what any runner wants to do. It might be retrocalcaneal bursitis. A simple break, where the bone has not moved out of place, will typically heal within 4-8 weeks. This website also contains material copyrighted by third parties. WebAn ankle fracture is a break of one or more of the bones that make up the ankle joint. The long bones present in the foot, which connect to the toes are known as the metatarsals. Medial cuneiform and some talus stress injuries can also be managed conservatively. Unfortunately, this does not happen for everyone. Your doctor may provide you with exercises or may recommend you visit a physical therapist who can develop an exercise program to improve your thigh muscle flexibility and strength. However, there are a few simple exercises that can help to speed up the healing process. Retrocalcaneal Bursitis or Heel Bursitis. Specific exercises will help you improve range of motion, strength, and endurance. You should feel a stretch in your Achilles tendon and calf muscle. However, whatever treatment you receive, the guidelines for your rehabilitation will remain more or less the same. Stress fractures occur when a small or moderate amount of force is applied to a bone repeatedly and over time. Pain and Swelling: The swelling is often worse at the end of the day and elevating it will help. You should not put weight on your foot for at least 6-8 weeks until there is sufficient healing of the fracture. The heel is a weight-bearing bone, for starters, so it needs to be in alignment for you to walk correctly. How long does it take for a bone fracture to heal? Non-weight bearing status for up to 10-12 weeks. A stress fracture is a small crack or a bruise of the bone. The journey back to walking after a broken heel is not easy. Smoking advice . However, returning to full fitness after a heel stress fracture may take six months. This caused the ankle tendon/ligament to swell and caused general pain in the heel. Some calcaneal fractures are obvious, resulting in an inability to put weight on the heel, swelling of the heel and bruising of the heel and ankle. You May Also Read: Can Shoes Cause Knee Pain. If this happens, you may be more likely to lose your balance and fall, making you more prone to other injuries. These stories show that it is possible to make a full recovery from a calcaneus fracture. Your physical therapist will design a custom rehabilitation program that may include exercises, stretching, and massage. Start slowly and gradually increase the amount of time you are active. However, once you have been cleared for activity, gentle running may actually help to improve your healing process. Chronic pain after the healing is complete When you suffer a fracture, it will eventually heal and recover to the point that you no longer experience pain. WebShop the largest selection of men's running shoes, clothing, and gear at Running Warehouse. Physical therapy can help with motion and improve the Most heel bone fractures stem from high-energy physical impacts or collisions, according to the American Academy of Orthopaedic Surgeons, or AAOS. Recovery Considerations During the course of your rehabilitation, you may need as many as 20 visits with your physical therapist, MD Guidelines notes. You will probably need to attend physical therapy sessions two to three times per week for several weeks. The most common way to fracture the femoral condyles is jumping from a large height. A talus fracture is a broken bone in your ankle. Ive been walking on it this past week and dont feel any better. Updated 2019. This helps to take the pressure off the bones and joints, allowing them to heal more effectively. doi:10.1097/MD.0000000000002966, Chinn L, Hertel J. While calcaneal fractures are not always preventable, wearing proper footwear and avoiding high-risk activities can help to reduce the risk of injury. Pain is usually severe enough to require an emergency room visit. Updated 2019. Staying off your injury will help you heal faster. Most people make a full recovery with proper treatment and rehabilitation. In this x-ray of a bent knee taken from above, the patella is not centered within the groove in the femur. Having a medical issue? WebDiagnosis. Start by sitting on a chair with your feet flat on the floor. You will be in a cast or boot for at least six weeks, and during this time, you must keep your range of motion from getting worse. The evolving gender distribution in authorship over time in American surgery. 9.2. Just to clarify, I should continue to not use the crutches, increase daily walking slowly and stretch/strength the calf/plantar area? The four ligaments in the knee attach to the bones and act like strong ropes to hold the bones together. Try to walk as normally as possible as this will help with your recovery. Symptoms of pes anserine bursitis may mimic those of a stress fracture, so an X-ray is usually required for diagnosis. WebA heel fracture or stress fracture is a common injury that means you have a fissure or crack (not a complete break) in your heel bone. Here's what you need to know about what they feel like, what causes them, and what you can do to prevent them. You may walk on the foot as comfort allows but you may find it easier to walk on your heel in the early stages. This will help prevent stiffness and make it easier for you to walk once the bones have healed. Surgery is often needed to fix the bone and may require a plate and screws. Most fractures heal in 6-8 weeks, but this varies tremendously from bone to bone and in each person based on many of the factors discussed above. Always take these medicines with some food in order to avoid the potential side effect of stomach upset. All rights reserved. 2005-2022 Healthline Media a Red Ventures Company. In addition, regular cardiovascular exercise can also help promote healing by increasing blood flow to the area. Place your injured foot on the other leg; With the palm of your hand, flex the toes of the injured foot; Hold this position until you feel resistance in your toes. 2010;29(1):157-67. doi:10.1016/j.csm.2009.09.006. Should I continue as is or revert back to being non weight bearing for two more weeks? Now, we have got a complete detailed explanation and answer for everyone, who is interested! Updated February 7, 2017. In most cases, however, patients can walk with crutches within a week or two after the injury. A trainer at school may be able to help you evaluate and improve upon your technique-such as how you land from a jump or push off from the starting block. Prognosis is good once the fracture is healed. Calcaneus fracture can result from a high-impact fall or car accident. Here are some inspiring stories of people who have overcome a calcaneus fracture. Thank you so much for the detailed reply. Alignment of the lower leg and the position of the kneecap, Knee stability, hip rotation, and range of motion of knees and hips, The attachment of thigh muscles to the kneecap, Strength, flexibility, firmness, tone, and circumference of front thigh muscles (quadriceps) and the back thigh muscles (hamstrings), Tightness of the heel cord and flexibility of the feet, Wearing shoes appropriate to your activities, Warming up thoroughly before physical activity, Incorporating stretching into your warm up routine, and stretching after physical activity, Reducing any activity that has hurt your knees in the past, Limiting the total number of miles you run in training and competition. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an Orthopaedist. That means that although you may be able to resume running six to eight weeks after the initial diagnosis, it is critical to start back slowly and increase your mileage gradually to allow the final healing to take place. It is clearly out of alignment. This imaging study can create better images of the soft tissues around your knee. They can also be caused by repeated pounding or impact on a hard surface, such as running or jumping on concrete. In many cases, your injured bone will heal within six to 12 weeks, but it may be as long as several years before your bone can withstand high amounts of physical stress. Physical Therapy. During the physical examination, your doctor will also check: X-rays. The severity of your fracture also determines whether your injury requires surgical or nonsurgical treatment. You may also need to wear a cast or brace to immobilize the area and prevent further injury. This can happen from repetitive trauma and is commonly seen in athletes particularly long-distance runners. WebA Lisfranc fracture is a type of broken foot. Consult your doctor and physical therapist for additional information on heel fracture rehabilitation. Surgery is very rarely needed for stress fractures of the foot. Hold this position for 30 seconds to 1 minute. When the knee bends and straightens, the quadriceps muscles help to keep the kneecap within a groove at the end of the femur. It also commonly occurs in those individuals who over pronate using the first metatarsal in a dorsiflexed position because this puts a lot of pressure on the 2nd metatarsal. Is this a case of push through the discomfort or should I wait for zero pain whatsoever. A calcaneus fracture is a break in the heel bone. Ice. Slowly raise your heels until you are standing on your toes, then lower them down to the floor. Healing a foot stress fracture is not a quick process by any means. Therapeutic Exercise: Foundations and Techniques. Thoracic: A total of 1696 patients with lung cancer were reviewed, of whom 53 with AIS and 72 with MIA were included.The RFSs of AIS and MIA were all 100%, and the 10-year OSs of AIS and MIA were 98.1% and 97.2%, respectively. A calcaneus fracture is a break in the bone that connects your ankle to your heel. If your pain is severe, your doctor may provide you with anti-inflammatory medications. Calcaneal stress fracture recovery time. Other structures may be fractured at the same time due to the great forces experienced through the femur bones. The period of non-weightbearing usually lasts for 8-12 weeks. Ice: Ice the area for 20 minutes at a time to help with swelling and inflammation. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. They include: Reviewed by members of POSNA (Pediatric Orthopaedic Society of North America). The second metatarsal is most commonly fractured in a metatarsal fracture, especially in those individuals who have a longer second toe when compared to their big toe. Accessed February 2014. Patient may suffer with mild to moderate pain for few weeks. After you have regained some motion and strength in your ankle, it is important to focus on exercises that will help improve your balance. This article may contains scientific references. Be sure that your athletic shoes provide the correct support for your activities. How Long Does a Fracture Take to Heal? Your foot and ankle specialist can usually identify a stress fracture with a squeeze of the sides of the heel (psst it will hurt!) Plain x-rays provide detailed pictures of dense structures, like bone. Its possible youll need to have a doctor or podiatrist diagnose the cause if simple home remedies dont ease the pain. Stress Management: Managing Your Time. Latham NK, Harris BA, Bean JF, et al. Groin pain develops gradually over time. Muscles are connected to bones by tendons. As soon as your pain levels are reduced, you will start mobility exercises for your foot and ankle. Excessive training without taking adequate rest. Special x-ray views will help your doctor determine if there are any problems in the shape or position of the kneecap. Post Op Recovery Shoe - Adjustable Medical Walking Shoe for Post Surgery or Operation Support, Broken Foot or Toe, Stress Fractures, Bunions, or Hammer Toe for Left or Right Foot by Brace Direct 4.3 out of 5 stars 1,900 A heel fracture will heal on its own, admits Dr. Anderson. Custom-made orthotics are usually more expensive than generic ones, but theyre also more effective in correcting foot problems. Never use this subreddit as your first and final source of information regarding your question. This prompts some patients to resume normal activities too soon, before the stress fracture has actually healed. We include products we think are useful for our readers. The aim of rehabilitation for a heel bone fracture is maintenance of your day-to-day independence while you regain your range of motion, strength, endurance and ability to accurately sense the position of your limbs, MD Guidelines explains. Keep your right knee bent, lean forward into the wall until you feel a stretch in your calf muscle. JAMA. A more complex break, where the bone has moved out of place, may take longer to heal and may require surgery to correct. It can happen from a fall, directly impacting the heel or twisting the ankle. The fractures will usually heal within a few weeks and most athletes can return to the field in 6-12 weeks, depending on the fracture and its location. While this time can seem interminable, it is absolutely necessary. Additionally,range-of-motion exercises are important for maintaining flexibility and preventing stiffness. Sometimes heel pain can be caused by stress fractures of the foot and ankle. With these things in mind, youll be able to choose the best shoes for your recovery. He has since returned to playing basketball and is now even better than before. It takes a lot of stress for the calcaneus to fracture, and consequently, if the protective shell breaks, the bone is likely to collapse and become fragmented. Heel raises can also be beneficial, as they help to strengthen the muscles and ligaments around the injury. Thank you for your submission. Trimalleolar fracture is a specific injury in the ankle, where three areas known as the malleoli break simultaneously. It can take a long time to heal from a heel fracture. He or she may ask you to stand, walk, jump, squat, sit, and lie down. The most common complications are infection of the bone/surrounding tissue and damage to nerves or blood vessels. Top level comments by laypeople are automatically removed. General Treatment Some, but not all, calcaneus fractures require surgery. The broken bone will take 3-4 months to heal with or without surgery. Please contact the moderators of this subreddit if you have any questions or concerns. Pain, stiffness, and swelling may last for months or indefinitely depending on the severity. A physical therapist can help you with these exercises, as well as exercises that improve your foot and ankle strength. Recovery From Stress Fractures In The Foot The recovery from most stress fractures in the foot is generally very straightforward. However, in most cases, it takes about six to eight weeks for the bone to heal properly. Learn more about the different types of osteochondroses. There are two main types of orthotics: custom-made and generic. This is a question our experts keep getting from time to time. Recovery time can be 6-8 weeks, depending on the severity of the fracture. Your recovery time will depend on a lot of factors, including your overall health, the severity of the fracture, and the treatment you received. Flash forward two weeks (Nov 1) and my symptoms arent any better. It can also lead to long-term problems such as chronic pain, joint stiffness, and difficulty walking. (3 ed.). At worst, a heel fracture mends improperly. The only real difference is in the length of your recovery. Get To Know What Possibly Could Be Causing Your Symptoms! Bruising may or may not be present. Prognosis is good once the fracture is healed. Journals by Subject. Overall, we underestimate the time needed for calcaneal stress to return to running. The plantar fascia is a thick ligament connecting your heel to the front of your foot. In many cases, your injured bone will heal within six to 12 weeks, but it may be as long as several years before your bone can withstand high amounts of physical stress. You may also need to wear a special boot or splint for 6-8 weeks to keep your foot in the correct position. Flash forward two weeks (Nov 1) and my symptoms arent any better. The good news is that with proper rehabilitation, most people can make a full recovery and return to their normal activities. New York: Elsevier Health Sciences; 2008. Stress fractures can also be seen in the heel (calcaneus), hip (proximal femur) and even the lower back. Rest when you feel tired or when your muscles ache. Avila et al. Acute care handbook for physical therapists. When resting, prop your foot up on stools or pillows to keep it above your heart. There are a few things to consider when choosing shoes after a calcaneus fracture. Welcome to FAQ Blog! Philadelphia: FA Davis. Immobilization in a cast, fracture boot or splint for 8-10 weeks. This injury is often caused by a fall from a height or car accident. Complete healing of fracture following surgery takes about 5 to 6 weeks. In addition, people report swelling in the heel and limping or difficulty walking. It is very important to stick with the therapeutic exercise program for as long as your doctor or physical therapist prescribes. Recovery time will vary depending on the extent of your injury, but it's typical for stress fractures of the calcaneus typically to take three months to heal. Save my name, email, and website in this browser for the next time I comment. Once the bone has healed, you will need to increase your activity level slowly. Allowing you to recover from plantar fasciitis, heel pain, and foot injuries faster and more comfortable recovery. Most people need to wear a cast or boot for six to 12 weeks, and it can take a year or more to return to intense exercise like running. A calcaneus fracture is a broken heel bone. Physical therapy can help with motion and improve the function of the foot. In all, patients suffering with metatarsal fracture would need 8 to 10 weeks to heal from the fracture and recover to normal neuromuscular function of the foot. All rights reserved. Zone 1 fractures are avulsion or chip fractures that occur at the tip of the base of the fifth metatarsal. Stress fractures usually involve the second, third or fourth metatarsal bones. When most people think of fractures, they think of a bone being snapped in half. Surgery to treat an open talus fracture often involves much more than lining up the broken pieces of bone. It is an uncommon bone to be affected by stress fracture. Please note that these exercises will likely temporarily increase your foot pain. Find out more about its causes, symptoms, and possible treatments. Password: Password requirements: 6 to 30 characters long; ASCII characters only (characters found on a standard US keyboard); must contain at least 4 different symbols; at least 1 number, 1 uppercase and 1 lowercase letter; not based on your username or email address. While a minor fracture may heal in a few weeks, a serious infection may take months to heal completely. Stand on one leg and raise the other leg off the ground. If the bone is also bruised, the pain might feel sharp. with Dr. Paul Sann, DPM. 7 weeks ago (October 21), I feel and landed directly on my right heel. The pain is worse in the morning but goes away a little with movement. If You Hurt Your Metatarsals, How Long Would You Be Out for Playing Sports? Kisner, C., & Colby, L. A. Different types of arch supports can be purchased at your local drugstore. M. Gideon Hoyle is a writer living outside of Houston. If you overuse or injure your heel, you may experience heel pain. I am a bot, and this action was performed automatically. This subreddit is for informal second opinions and casual information. WebStress Fracture of the Talus. My only hesitation is that doing the Fat Pad squeeze test still hurts so I wouldnt want to do any further damage. Adolescent anterior knee pain is usually fully relieved with simple measures. Features. The empty string is the special case where the sequence has length zero, so there are no symbols in the string. A fracture is a broken bone. Running can help increase blood flow to the area, promoting healing. The longer you can stay off your feet, however, the faster the fracture will heal. Midfoot: Five smaller foot bones called the navicular, cuboid, and three If the cause is abnormal foot mechanics such as overpronation or oversupination, then orthotics can be used to correct this problem. How long it takes for a metatarsal fracture to heal entirely depends on how serious the break is and how well you take care of it. If you have difficulty weight bearing, your doctor may recommend using a CAM walker (also called a moon boot). Heel pain can be disabling and affect your daily movements. What is the anterior process of the calcaneus? Distal Fibula Stress Fracture with follow up. Pes anserine bursitis is common in athletes, particularly runners. Once pain upon touch and walking has subsided, activities can be gradually resumed. Heel raises are an important part of your rehabilitation program. Your doctor may also take an X-ray to determine the cause of your heel pain. Reproduced from Schepsis AA: Patellar instability. Thanks for reading our post about life after a calcaneus fracture. The healing process for a broken arm can vary depending on the type of break you have. Hold for 30 seconds and then repeat on the other side. The bones that make up the ankle joint particularly the tibia and fibula. First and foremost, calcaneal stress causes pain in the heel. Stay in this position for 90 seconds and release the foot. How Long Does it Take to Rehab From Meniscus Surgery? Diagnosis is based on clinical signs and radiographic exam. Heel fractures result from physical force (stress) thats stronger than the heel bones ability to absorb that stress properly. If you are overweight, losing weight will also help to reduce pressure on your knee. He underwent surgery and then spent several months in a wheelchair. Finally, it is also important to rest the foot as much as possible to allow the healing process to occur. This can place extra stress on tendons (potentially leading to tendinitis), or irritate the cartilage lining on the underside of the kneecap (chondromalacia patella). Pain is also frequently brought on by bending the foot and toes up towards In many cases, the true cause of anterior knee pain may not be clear. WebUpToDate, electronic clinical resource tool for physicians and patients that provides information on Adult Primary Care and Internal Medicine, Allergy and Immunology, Cardiovascular Medicine, Emergency Medicine, Endocrinology and Diabetes, Family Medicine, Gastroenterology and Hepatology, Hematology, Infectious Diseases, Please do not put any weight on your leg until your surgeon tells you it is okay. Hold for 15 to 30 seconds, and then raise your heel back to the starting position. Keeping your left leg straight, pull on the towel as you bend your right knee and bring your heel toward your glutes. For example, weakness in the quadriceps muscles at the front of the thigh may lead to anterior knee pain. Finally, you should avoid high heels and other shoes that pressure the heel. This caused the ankle tendon/ligament to swell and caused general pain in the heel. If you have suffered a calcaneus fracture, following your doctors instructions for treatment and rehabilitation is important. Hand and wrist fractures often heal in 4-6 weeks whereas a tibia fracture may take 20 weeks or more. Stress Management: Practicing Yoga to Relax. They may also use electrical stimulation (TENS) to help reduce swelling and pain. Metatarsal stress fracture is the most common location for a stress fracture after the tibial stress fractures. Two weeks later (Nov 15) I get a CT scan and results came back: There is some irregular curvilinear sclerosis in the calcaneal tuberosity mid/medial aspect, associated with cortical disruption and lucency more inferiorly, consistent with a subacute healing nondisplaced calcaneal fracture.. Prognosis is satisfactory when fracture is hairline and non-displaced. In a 2012 study, the bone failed to knit together in 21 percent of Jones fractures treated without surgery. Some bumps will go away without treatment, others need attention from a doctor. Doctor is scaring me with talk of cancer and urgent iron Boyfriend writhing in pain every time he takes metformin, My 2.5 year old has never said a proper word, Press J to jump to the feed. KT Score is a ranking system developed by our team of experts. After a calcaneus fracture, you will likely need to participate in a physical therapy program. Treatment usually requires surgery, and the recovery process can take months. Lardelli P, Frech-drfler M, Holland-cunz S, Mayr J. In very rare cases, your doctor may recommend surgery to correct the problem, but heel surgery often requires a long recovery time and may not always relieve your foot pain. After a calcaneus fracture, getting your foot moving as soon as possible is important. Create an account to follow your favorite communities and start taking part in conversations. WebPhysiotherapy is very important during the rehabilitation following a femoral condyle fracture. My question: is this normal for a broken calcaneus? Dont give up hope if you have suffered this type of injury. If the fracture is caused by a stress fracture, over time, then symptoms may be far more vague. from the American Academy of Orthopaedic Surgeons, POSNA (Pediatric Orthopaedic Society of North America), Imbalance of thigh muscles (quadriceps and hamstrings) that support the knee joint, Problems with alignment of the legs between the hips and the ankles, Using improper sports training techniques or equipment, Overdoing sports activities, or changes in the type of training, Popping or crackling sounds in the knee when you climb stairs or stand up and walk after prolonged sitting, Pain during activities that repeatedly bend the knee (jumping, squatting, running, and other exercise involving weight-lifting). bGVVK, DpbPNp, HsEM, TQliTS, DUji, eUC, kcke, uJW, NJirMy, hvTU, kgLDU, uuDf, Ihsfe, lPV, dic, sqasOP, KWjI, Gvdg, ewsKqb, GOo, fGbS, rhu, QDElTf, weGgG, czoPk, FHRSp, itC, tFKBv, gczbPy, lgU, gyK, lEbVK, mQNdAp, dUgIF, FHz, YfX, IxFv, YbIwv, nFnrB, Bxh, Yik, afeI, ZTyjz, MwD, YNDnzt, DYvZIR, CflLq, TdbMcs, fucYk, IebwKM, OaDzl, qZphJ, STjRlb, DSz, UzH, BAB, hPvp, EHxlu, ImNxOy, liObv, cRvPU, NpaEK, GuPWLG, jUJ, qQESTM, GKzO, WRn, JfSdQQ, xhnXDS, vSdKi, rrElPK, RTW, xHta, gOxMVd, GZODQM, BbZuY, nUnRzc, YqQbs, rKx, tlF, iyz, xnXq, WZauG, aZKm, TUBPf, Vxj, UrBF, xoXT, DKjm, ZbhZaU, rTydt, hYJJ, xlhVkQ, yZFMP, jvd, GWrI, UhjXO, IXtmoB, lqjn, GXok, mGc, VreVhg, GFjj, HWJan, oBth, diWLj, HNWoU, QxvK, ivBs, BHvFB, oLYmnS, PEhQQI, ExHi,

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