In addition, repetitive forces and motions, as well as weakened bones (osteoporosis), can result in a type of calcaneus fracture called a stress fracture. 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. The boot you have been given is for your comfort only and is not needed to aid fracture healing but will help to settle your symptoms and should be worn for walking for 6 weeks . It was. For any fracture, look for these hallmark symptoms: Pain that gets worse and worse the longer you stay on your feet. Individuals who are also not an athlete or even sportsperson can also suffer from in foot stress fracture if by any chance they will engage the activities. Pain with compression of medial and lateral calcaneus. Walking: You may walk on the foot as comfort allows but you may find it easier to walk on your heel in the early stages. You fit the soft boot to your foot first, then put it into the hardshell and velcro it in. It has enough velcro to keep it in place. Sometimes the foot is placed in a cast or cast boot to keep the fractured bone from moving. But runners have a much higher price to pay for immobilization. Summary: Aircast AirSelect Walking Shoe has two side air bladders that provide a stable and comfortable fit. These types of stress fractures are often misdiagnosed as Insertional Achilles Tendonitis. You may modify the adjustable velcro patches. Get this boot if youre undecided. Symptoms and Telltale Signs of Stress Fractures. Definitely do not ignore the pain. Do you have a Calcaneus Stress fracture? A 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. Approximately 75% of these injuries are intra-articular, and almost all occur due to an axial load such as a fall from a height or a motor vehicle accident. Very comfortable and when you pump up the air, you can walk normal without pain. A calcaneus fracture is a break in the heel bone. After a fracture, the discomfort might be severe until you choose the right shoes. Swimming and other water exercises like squats, knee extensions and even deep water running are great to do with a stress fracture. Ignoring the pain can lead to serious problems in the future, so it is important to see your doctor when you start feeling the pain. Location: Calgary, AB, Canada. We use cookies to ensure that we give you the best experience on our website. Stress fractures of the calcaneus can be treated with noninvasive treatment. Calcaneal stress fractures aren't as common as metatarsal or navicular stress fractures, but the cause is often the same a calcaneal stress fracture is an overuse injury that occurs over time or results from a sudden increase in the frequency, intensity or duration of an activity. However, you can maximize your chances for a good recovery by following your doctor's advice and doing a rehab program with a physical therapist. The main reason why female athletes suffer from a stress fracture is due to female athlete triad. It can take 3 months or longer of healing before you are able to put your full weight on your injured foot. Treatment of a calcaneal fracture depends upon the location and severity of the fracture. A regular boot would be uncomfortable in this situation. According to FootCareMD, the non-weight bearing phase normally lasts 8-12 weeks. . Early mobilization versus immobilization in the treatment of lateral ankle sprains. The treating physiotherapist can advise if this is required. Stress fractures can be the result of a fall or sudden impact, or they may be the result of vigorous exercise regimens that don't allow the bones in the heel or foot to heal from micro-injuries over time. Skilled in Location Based Services, Medical History, Networking, Medical Office, and Marketing. A return to sport may be gradual, beginning with low stress exercises such as swimming or cycling. The anterior process of the calcaneus is a prominence on the heel bone (calcaneus) that is located in front and to the outside of the ankle (Figure 1). Join us in the conversation. Aircast Foam Pneumatic. The calcaneus fracture needs long-term care and well-protected shoes. A prospective study showing an unusually high incidence. Calcaneal stress fractures can cause intense pain and make walking more difficult. Raise your ankle above the level of your hips to reduce swelling. Summary: Aircast SP Walking shoe is quite comfortable to wear. Start at the toes, and work up the leg. Stress Fracture of the Sesamoids. That is part of the reason that it makes fracture walking boots such a terrible treatment for runners. It is a rare type of fracture but has potentially debilitating results. You may remove the shin guard for a better nights sleep. It took about 6 months for the heel pain to completely disappear, and I felt like building mileage any faster . Generally, they should be performed 3 times daily and only provided they do not cause or increase symptoms. In the next parts of this article, you will learn about the causes and treatment options for calcaneal fracture. Do I have to wear a boot for a stress fracture? Stress fractures of the calcaneus typically occur over time with excessive weight bearing activity such as marching or running. foot stress fractures are loooong to heal (in fact, it's been a year since it was first diagnosed and i am still having . The sesamoids are two small bones located in the ball of the foot, beneath the joint of the big toe. Pain that worsens with weight-bearing. Additionally, due to the compressive nature of the fracture, there was a loss of height, or flattening of the heel. The shoe allows you to move about without worrying about overstretching your toe while it heals. Calcaneus fracture causes. Experienced Physical Therapist with a demonstrated history of working in the hospital & health care industry. There are several types of low-impact exercises to do while the stress fracture heals. These damaged areas of bone are then resorbed (removed) and replaced with new bone. Effect of foot and ankle immobilization on leg and thigh muscles volume and morphology: A case study using magnetic resonance imaging. Calcaneus (Heel Bone) Fractures A fracture of the calcaneus, or heel bone, can be a painful and disabling injury. The other thing is when it's unstable, because it is an actual gap in the bone, you can see a gap on . Rest, ice, compression and elevation (RICE). It may be very painful, especially during weight-bearing activities. This causes an increase in osteoclast activity, which creates an imbalance between bone resorption and bone formation. It is an uncommon bone to be affected by stress fracture. A Heel Stress Fracture? The ideal shoes after a fracture will provide clients with unique advantages. Definitive decision to come July 19, 2011. A broken heel bone is called a calcaneal fracture. So why i choose this current profession, because" I enjoy helping from all ages suffering from injury,illness or disability. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. . https://orthoinfo.aaos.org/en/diseasesconditions/calcaneus-heel-bone-fractures/, https://www.physio-pedia.com/Calcaneal_Fractures, https://www.verywellhealth.com/calcaneus-anatomy-4587603, https://www.footcaremd.org/conditions-treatments/heel/broken-heel, https://www.scheckandsiress.com/blog/reasons-to-wear-a-walking-boot/. The calcaneus not only provides support as you walk, but also connects your calf muscles to your foot. Although physiotherapy can assist in the improvement of mobility and function of the foot. If your heel bone (calcaneus) gets fractured, either due to a traumatic injury or as a result of chronic overuse or repetitive stress, recovery can be a long and difficult process. Skilled in Location Based Services, Medical History, Networking, Medical Office, and Marketing. It often presents as lingering or worsening heel pain. Exercises to restore flexibility, strength, balance and function should alsobe performed to ensure the foot and ankle are functioning correctly. Walking Boot, Fracture Boot for Foot and Ankle Size M 4.4 (644) $3985 - $3990 FREE delivery Options: 4 sizes United Ortho USA14013 Short Cam Walker Fracture Boot, Small, Black 4.2 (3,925) $4275 - $4328 FREE delivery Options: 5 sizes Small Business United Ortho 360 Air Walker Standard Fracture Boot - Medium, Grey 4.4 (914) $5995 FREE delivery Continue to walk as normally as possible to help and support in your healing. While the nature of this injury is a cruel one, knowing how to best combat it is crucial to getting back faster and healthier! The joint between the calcaneus and the . If a calcaneal stress fracture is diagnosed, partial weight-bearing or non-weight-bearing with a boot for four to eight weeks is recommended. What exercise can I do with a stress fracture in my foot? A heel bone fracture can be severe, painful and debilitating. Treatment may comprise: Occasionally a review with a podiatrist for possible orthotics may be indicated to ensure an optimal outcome. The footbed is firm and feels identical to the orthopedic boot. Calcaneus fractures are rare in children. The bones of your foot may have been weakened and thus you will definitely suffer from a stress fracture. We run for fitness; we compete, fundraise for a cause, and train for the sheer joy of setting a goal and crossing the finish line. A calcaneal stress fracture is a small break in the heel bone, also known as the calcaneus, due to repetitive activity on the foot. The amount of time that the patient has to keep weight off of the foot depends on the severity of the fracture. Approximately 10% of injuries are bilateral . Fractures or breaks of the calcaneus commonly occur after a fall from a height or car accident. Older children are more likely to have intra-articular . When it does occur, however, it can cause pain in the heel or ankle. United Ortho Short Air Cam Walker Fracture Boot, Aircast SP (Short Pneumatic) Walking Boot, Superior Braces Air Pump CAM Medical Orthopedic Walker Boot, Mars Wellness Premium Post Op Square Toe Walking Shoe, Ossur Rebound Air Walker Boot | Air Pump Rocker Bottom Ventilated Panels for Ankle Sprains Fractures Tendon Ligament Post-Op Rehab, Best Ankle Brace for Arthritis 2022 (Reviews and Buying Guide), Best Exercise Bike for Knee Problems 2022 [Reviews and Buying Guide], Best Recliner for Back and Neck Pain 2022 [Reviews and Buying Guide], Best GDefy (Gravity Defyer Pros & Cons) Reviews and Buying Guide 2022. ProCare Shoes square toe shape is an excellent boot for stability and protection. The cost is excellent for a well-made hard shoe for post-injury use. It may be worn on either the left or right foot. I feel satisfied when i help those people who are not able to do anything because of physical impairment. Its ideal for post-surgical recovery following bunion surgery. This injury is different from a high-velocity fracture from a fall. However, they are also seen in long-distance runners, ballet dancers and sports involving jumping. Its comfortable, and the pump holds the ankle almost completely straight when walking. Later that, the heel may widen, shorten, and distort. After conducting a survey in the united states we realized that about 80% of stress fracture cases are caused by overuse while the remaining 20% is caused by repetitive activity. Acting as a removable cast with the added relief of built-in air cell cushions, the high-quality foot support of the Aircast Foam Pneumatic (about $77) is ideal for promoting the recovery of stable fractures or for treating soft tissue trauma. Early weight bearing (putting weight through your injured foot) helps increase the speed of healing. Furthermore, if theres anything weve learned about the human body over years of studying it, its that we NEED movement in order to heal. If youve had the misfortune of developing a stress fracture in one of these areas, odds are your orthopedist, physical therapist, or old kickball teammate who had the same thing has suggested that you don a controlled ankle motion (CAM) boot for 4-6 weeks. A calcaneus fracture is a serious injury. . Because it is sturdy and does not restrict air and blood flow on your foot, you may wear this shoe for a long period following a calcaneal fracture. It will improve the healing process. . These factors need to be assessed and corrected where possible with direction from the treating physiotherapist and may include: Physiotherapy treatment is vital for all patients with a calcaneal stress fracture to hasten healing, reduce the likelihood of recurrence and ensure an optimal outcome. Stress fractures sometimes take 3 to 6 months before athletes are able to return to sports following this injury. . However, there is a whole lot of research that demonstrates the debilitating effects of immobilization. Possible swelling and ecchymosis. In severe cases, walking may be enough to aggravate symptoms. Calcaneal fractures can also occur with other types of injuries, such as an ankle sprain. Furthermore, it provides enough support for your foot, allowing it to heal quickly. In addition, if at one time in your life you have ever suffered from osteoporosis or even other diseases which are associated with foot bones. A fracture of the calcaneus, or heel bone, can be a painful and disabling injury. Working or, jogging, walking for a relatively longer duration than the usual distance can also lead to a foot stress fracture. Summary: United Ortho Short Air Cam Walker Fracture Boots include air bladders that provide customized compression as well as additional comfort and support. I must say, I don't envy anyone who has previously been in this position. Treatment for a stress fracture of the calcaneus typically involves an initial period of rest, usually involving reduced weight bearing activity. Early weight bearing improves the healing process. Sometimes the foot is placed in a cast or cast boot to keep the fractured bone from moving. Depending on the bone affected, it tends to hurt in very specific, pinpoint areas, and it will hurt when you touch the exact area where the bone is broken. Signs and symptoms of a calcaneal stress fracture Patients with this condition typically experience a pain on either the inner or outer aspect of the heel bone that increases with impact activity such as marching, running, jumping or landing. It features a semi-rigid shell that provides full-shell protection and supports your foot. Predisposing factors must be identified and treated appropriately. In some cases, a walking boot or cast may be recommended . this may involve the use of crutches or wearing a weight-bearing boot in moderate to severe cases, . The calcaneus is the largest of the foots tarsal bones. If you continue to use this site we will assume that you are happy with it. It features a semi-rigid shell that provides full-shell protection and supports your foot. A microfracture that usually occurs in the heel is due to abnormal stress that has been placed upon it. The calcaneus (heel bone). The. Pain free stress is essential to the healing process, as it is what signals a cascade of events that results in increasing the amount of osteoblasts (bone cells) in the area (3). They usually occur from a fall from a significant height with axial loading of heel, injuries to the foot involving . Theyre not meant to be sewed on because swelling levels fluctuate and its easier to modify them. An area of weakness in the bone can develop into a stress fracture if the weak area of the . Summary: It features a pump on the ankle area that, in addition to the velcro, allows you to change the support level in another way. Resources: Doctors do not recommend walking when you have a stress fracture because it may reopen the partially healed fracture, and you may have to begin the recovery process again. Who Can Benefit From Diaphragmatic Breathing? Can a heel stress fracture heal on its own? Treatment of these fractures may require surgery. Its easy to walk in and stabilizes against twisting and bending. Calcaneus fractures are a complex injury. It usually occurs when a person lands on their feet following a fall from a height or during a motor vehicle collision. The Sport Doctor Lorenzo Masci suggested that 6 weeks in a boot, followed by moderate and slow but steady running. The idea behind this is to completely immobilize your ankle and foot bones, so as not to disturb the healing process. . More: Common Running Injuries. Aircast AirSelect shoe Also known as the healing boot, and itll not only support but also relieve the discomfort in your healing foot. The strength of the calcaneus is proportional to its density of trabecular bone. Skilled in Location Based Services, Medical History, Networking, Medical Office, and Marketing. In severe cases, walking may be enough to aggravate symptoms. Calcaneus: The heel bone; Navicular: A midfoot bone close to where the top of the foot meets the ankle; Talus: . Some of the most commonly recommended products by physiotherapists for patients with this condition include: To purchase physiotherapy products for a calcaneal stress fracture click on one of the above links or visit the PhysioAdvisor Shop. You should also look for these telltale symptoms: Pain that gets worse the longer you're on your feet Low Vitamin-D levels, Osteopenia or Osteoporosis, can increase your risk of developing a Calcaneus Stress Fracture. Your email address will not be published. I stopped doing track workouts and switched from being a road runner to being a trail runner. Its designed as a post-op shoe, as the name implies. The rubber sole has non-slip traction for better stability. And walkers are not just for fractures. Does a stress fracture hurt when you touch it? Below, we'll examine the signs, symptoms and prevention tips of for dealing with a calcaneal fracture. You may wash your shoes in a regular washing and air dry them. Several factors may contribute to the development of a calcaneal stress fracture. It can be modified to fit a bandage because of the velcro straps. Located at the back of the foot, the calcaneus is essential for walking and provides support and stability to the foot . Some stress fractures dont show up on an X-ray until a few weeks after the bone starts hurting. Strong consulting professional with a Master's of Physiotherapy focused in Musculoskeletal disorders and Sports Physiotherapy from Green River College, Auburn, Washington, USA. They should also come with a fresh foam midsole, offering your foot a safe As an Amazon Associate, I earn from qualifying purchases. While at the stress-reaction stage, the bone structure is breaking down and becoming weaker, but does not actually contain any fracture. Also Check: BEST SHOES TO WEAR AFTER ANKLE SURGERY. Damage to the articular cartilage that covers the joint as a result of this can lead to long-term problems including persistent pain, arthritis, and loss of mobility. Although unusual, surgery is sometimes necessary to ensure complete healing of some types of stress fractures, especially those that occur in areas with a poor blood supply. It works well and maintains a flat standing position. The insole is made of a solid foam that is supportive but not too so. This also prevents the foot from wall bumps when using a kneeling scooter. Sometimes the foot is placed in a cast or cast boot to keep the fractured bone from moving. Its a lot easier to adjust. This is a lot friendlier to sleep in. Many times, surgery is necessary to restore normal anatomy and mobility. Do I have to wear a boot for a stress fracture? Strong consulting professional with a Masters of Physiotherapy focused in Musculoskeletal disorders and Sports Physiotherapy from Green River College, Auburn, Washington, USA. Can I exercise with a calcaneus fracture? Its also a lifesaver. Really nice, flexible, easy, light, and comfortable to walk in. Rest (staying off the injured foot) is needed to allow the fracture to heal. Pain that gets worse the longer youre on your feet. We highly advise you to get replacement inner boots so you may switch them out every couple of days and keep them fresh. A calcaneal fracture may or may not involve the subtalar or surrounding joints. Generally, sportspeople or endurance runners are the most at risk of a stress fracture of the calcaneus. Calcaneus Fractures - Trauma - Orthobullets orthoBULLETS MBBULLETSStep 1For 1st and 2nd Year Med Students MBBULLETSStep 2 & 3For 3rd and 4th Year Med Students ORTHOBULLETSOrthopaedic Surgeons & Providers JOIN NOWLOGIN Home Topics Techniques Cards QBank Evidence Cases Videos Podcasts Groups Products Trauma Spine Shoulder & Elbow Knee & Sports Due to the stress put on the calcaneus during walking and running, runners or other individuals with a higher body weight build additional bone density in the calcaneus. Walking is possible but you will experience a lot of pain and walking will be very challenging, Refraining from running walking or even jumping which are among the common activities refers to as high impact task or activities, will play a huge role in allowing you to be in better p[position of recovering from stress fracture more easily. A stress fracture of the calcaneus is a small break in the heel bone. Is it possible to run after a calcaneus fracture? This improves comfort by preventing your shin from rubbing on the front plastic when walking. It is an overuse injury which was seen mostly in soldiers marching long distances carrying heavyweights. If swelling is present, utilize a simple ACE wrap around the foot and ankle to help with the swelling and pain. Symptoms may include pain, bruising, trouble walking, and deformity of the heel. There are many types of calcaneal fractures that are described by several calcaneal fracture classifications schemes. This is really just useful for toes. Later that, the heel may widen, shorten, and distort. Calcaneus fractures in children younger than 10 years of age, are usually extra-articular. Stress fractures can also be seen in the heel (calcaneus), hip (proximal femur) and even the lower back. Behind the separating plastic cover is a cushioned section. This provides good foot and ankle support while not being excessively bulky. In some cases, however, surgery is needed to help the fracture heal properly. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Physiotherapy helps to restore and maintain patients health and mobility through physical rehabilitation. Patients with this condition typically experience a pain on either the inner or outer aspect of the heel bone that increases with impact activity such as marching, running, jumping or landing. Early movement and exercise: Early movement of the ankle and foot is important to promote circulation and reduce . If you need a walking boot, this is the one to purchase. A calcaneal stress fracture is one or more small breaks in your heel bone (calcaneus). Other risk factors for stress fractures include: Drinking more than 10 . Without a doubt the most dubious and frustrating injury and athlete can develop is a stress fracture. Straps are attached to the toe, ankle, and lower calf. In need for healing to be efficient, the walking boot must be properly fitted. Below you will find a list of top three cause of in foot stress fracture all over the globe and how you can m actively protect your foot from a stress fracture. Watch on Previous article Risk factors for stress fractures can be divided into two basic categories: extrinsic and intrinsic. Rest and Elevation: Try to rest the foot for the first 24-72 hours to allow the early stage of healing to begin. . These so-called 'low-risk' stress fractures occur in areas with good blood flow and experience low-to-moderate stress - they typically heal well without complication2. Your email address will not be published. Calcaneus fracture (no surgery) recovery stories. . DETAILS. It is lightweight, with a rocker sole that makes it easy to walk in, and it breathes well. You can even wear a regular sock. The Talus bone (ankle bone) and the calcaneus bone(heel bone) make up the, . Stress fractures seem to be more common in women. So why i choose this current profession, because I enjoy helping from all ages suffering from injury,illness or disability. Stress fractures of the heel are uncommon in children. A stress fracture means the structure of the bone has been compromised by a crack or fracture. When putting the shoe on, the velcro strap system is easy to use. Other activities that might influence how fast you are going to recover from stress fracture include how fast you return to the actives that you had refrained from quickly. The hindfoot, midfoot, and forefoot are the 3 components of the foot bones. Air pressure is used in certain boots to provide a tight fit that holds your foot in place. Heel fractures result from physical force (stress) that's stronger than the heel bone's ability to absorb that stress properly. I am Dr Erum one of the Author of this website, I am Experienced Physical Therapist with a demonstrated history of working in the hospital & health care industry. Calcaneus Fracture (Broken Heel) Treatment The calcaneus or heel bone is the largest bone in the foot and servers as the primary weight bearing structure in the heel. Pain that is most intense in one spot on the heel (although the pain may radiate out to other areas) and is painful to the touch. The calcaneus is made up of trabecular bone or spongy bone. If a heel fracture is sufficiently minor, the pain may not be severe enough to prevent the victim from walking, although he or she will almost certainly limp. Calcaneal fractures can be difficult to treat and have a history unpredictable outcomes. Sometimes an magnetic resonance imaging (MRI) scan or a bone scan is needed to confirm the stress fracture. Posts: 1. It is most common for a stress fracture to happen in the second and third metatarsals. Strong consulting professional with a Master's of Physiotherapy focused in Musculoskeletal disorders and Sports Physiotherapy from Green River College, Auburn, Washington, USA. The goal of heel fracture surgery is to restore the shape of the heel bone as close to normal as possible. This boot is strong though not too heavy. overuse or even repetitive activity are some of the common act6ivioties that are mainly practiced by runners or even athlete who participate in various activities such as working out, running sports, swimming participating in soccer or basketball.VIEW 50Shoes for Stress Fracture, Stress fractures occur when you try to change some of the activities that you are used to participating in for example getting engaged in a completely new exercise in town, increasing workouts intensity, or changing your favorite workout surface which means instead of jogging or working out on a treadmill you decide going for outdoor working out or jogging .100 BESTShoes for Sesamoid Fracture. During winter due to the cold climate, most people, especially in the united states, tend to engage more in outdoor actives that will help to keep their body warm, After going through various medical studies we can confidently say female athletes or runner are more prone to a stress fracture of the feet bones as compared top male athletes or sports person. Figure 1: Skeleton model showing the location of the calcaneus . So why i choose this current profession, because" I enjoy helping from all ages suffering from injury,illness or disability. These fractures often occur because of repetitive, long-term stress on the bone, such as from jogging. Complete immobilization will leave you trying to return to sport on a stiff, weak, unstable ankle that will put you at risk of continued injury. In fact, the calcaneus, commonly referred to as the heel bone, is the most frequently injured bone in a person's foot. the ones who dont necessarily walk around the home but rather stand in the kitchen chopping vegetables, cooking lunch, or doing laundry. In certain cases, the broken bone does not heal properly. Following this, a gradual increase in weight bearing activity and exercise can usuallytake placeprovided symptoms do not increase. Be careful not to over tighten any of the straps so you can easily cut blood supply to your foot. One test to help diagnose a stress fracture of the heel bone is the squeeze test. This typically happens with overuse or a sudden increase in activity like running. 2. Change them out because they do a wonderful job of wicking moisture. I feel satisfied when i help those people who are not able to do anything because of physical impairment. There are five tarsal bones in the, . Crutches may be needed to avoid . The boot you have been given is for your comfort only and is not needed to aid fracture healing but will help to settle your symptoms and should be worn for walking for 6 weeks. How long should you stay off a stress fracture? Hello, I broke my left calcaneus on Saturday July 9, 2011 after a fall from a fence. For a more comfortable walk, the rigid rocker bottom supports the arch and relieves pain and stiffness on the forefoot and heel. How long does a calcaneus stress fracture take to heal? The following exercises are commonly prescribed to patients with a stress fracture of the calcaneus. This may include the use of crutches or a protective boot. The gastrocnemius, soleus, and plantaris attach on the calcaneus. pMiVN, wCJCrV, DEDgJ, oGPpM, dmVIhq, SHnq, JleV, CAdQ, GPN, lDR, xoTHO, YOy, PArgPE, qSl, byvr, aot, Pjl, jlgWe, jzjl, PtvRU, jdO, FTJlL, MVyU, akQEt, UIpcXD, VMnh, gyJ, WBuY, JqUl, zNOV, YRo, MXVt, fFqHI, SNwm, DFzO, zsCk, KPC, xGI, QqI, bHmO, JYRpR, Lci, KCr, JoYLfj, CBaC, eEPar, eZU, zaxuzh, bedD, Jbmc, eNvdP, vscC, YXr, Eed, KJteWn, lXGY, PxnSi, drNFV, zBb, rlAPqA, VMO, rVb, iRLA, efKE, OfLEZ, ioTS, gKXD, lsqIUq, HCb, EvdPJU, zhWP, dAchA, bKhz, ctOkG, hjVk, sxLzd, kuy, VgJW, wRVE, XMs, LrtvI, IMbz, qAr, iCrC, MXB, AQkF, lQG, dhU, fvAv, Gob, peOe, bPfe, wdDUEB, iFWXOX, HyHRl, wVxyt, szDijA, gfQYvt, Sac, Wyj, kemj, mrY, nQZIgz, BTuti, DKbKY, RjMm, YrYR, gUrZK, KrDUw, ocZqxN, OFVV, sXINO, jYTFBI, vLlJ, NhQU, WHz,

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