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Ankle Fusion, Replacement or Amputation?

Posted , 7 users are following.

jonathan2412
jonathan2412

Hi all, looking for someone with first hand experience and thoughts - but feel free to add any updates!

 

?About 16 years ago I had a bad accident when I was knocked off my motorbike. I suffered multiple fractures of Tib + Fib, Talus and Medial Mellolus of the left leg/ankle. Over the years I have had internal nailing and fixation, tendon graft, tendon lengthening and a successful subtalar fusion. All the metal work has been removed.

?My ankle joint (tib/fib to talus) is in a very poor state of osteoarthritis. In Feb 2016 I had a debridement to remove spurs and to tidy things up. At that point I had 10 degrees of movement (plantarflexion) and could get the foot to neutral. Obviously not movement side-to-side following subtalar fusion.

?Now my foot is getting more painful again as the ankle joint is becoming more deformed and is pretty much bone-on-bone. My Consultant has ruled out doing any further debridement as just being a bit of a waste of time/money. My options seem to have come down to 1) Do nothing, take painkillers which can't go on forever, 2) a Total ankle replacement - which my Consultant is a bit hesitant about, I'm too active, tib/fib/talus alignment isn't as good as it could be and given I now only have about 5 degree of movement I'm unlikely to find any improvement in range of movement 3) Ankle fusion - most stable and pain free but with the subtalar already fused I'll have a solid foot with problems going up/down gradients, risk of further joints becoming arthritic etc 4) perhaps consideration to have BTK amputation, possible to recover to be able to run and walk and good function but of course not an easy route to take and has its own cons.

?I'm really struggling to make a choice. I know everyone is different but as someone who is active - gardening, running, cycling, walking the dogs and still young (46) I'm really worried about the outcome of a fusion. I'll not have the pain but how much will I be able to do? An ankle replacement might keep some motion but runs the risk of further surgery quite soon because of my activity levels (or at least desired activity). Maybe an amputation would ultimately result in a better outcome, no pain, learn to walk/run again and be quite active albeit with modifications to support living at home/work etc.

?If anyone has any thoughts or advice please share! Thank you!

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  • Winnig2018
    Winnig2018 jonathan2412

    Posted

    Hi Solider,, my ankle was crushed 25 years a go in a car wreck. i feel all your pain even as i type this message. I live in  chronic pain. on my 2nd TAR , fought a serious bone infection for 3 months after having my first TAR done 4 years ago.  then all of sudden a dam  bone infection pops up.  after the wreck that i survived  ortho team cut my pelvic bone grafted me ankle bone i wore a external fixature (with 2 Halo)  for a year. learn  to walk again just to have more suegerys.  its been a hell of 26 years. sometimes i fell like a amputation will have been better. i livw in chronic pain. pain killers  is hard with this epedemic of opoids in st. louis.  i do not know what to do know more. i have appt. comming up pain control.  have not work in 12 months they denied my disabiltity. and i sure there is more surgry to come.  an amputation sound hard....but i really feel like it might be easier.
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