Fused ankles – got one or know someone with one?

Looks very likely that I will be getting my right ankle fused in the next 3-4 months, just got to wait for the latest break to heal enough to formalise the assessment.

From what I read it isn’t a great option but better than amputation. First choice is still just to walk through the pain but not sure how realistic that will be.

So being positive, how much of a life changer is it? The only sports I really do are mountain biking and a bit of swimming. I like walking about but that had reduced since I last broke my talus.

The internet in this hospital is really slow and has taken about an hour to find the articles of which one was sort of relevant. professional or personal experiences welcome, even just links to good websites.
Cheers
Nick

Sorry to hear that mate. Done my r one 3 times but the first two were only minors.
Hopefully you’ll get some encouragement on here. You seem well liked by those who know you!
Apologies for lack of actual help, just wanted to pass on positive vibes!

American physio stuff

Bike radar forum

Try those two or put ankle arthrodesis cycling into google

Sorry to hear of the expected less than 100% perfect recovery Nick 🙁

Although it would seem that a fused ankle won’t stop you cycling. This thread suggests the issue is more which clipless pedal :

Pedal choice after ankle fusion?

Thanks for the link Ernie, that is pretty much what I was looking for. I could only ride flats after the last time I twunted the ankle but that time they didn’t fuse it.

I guess that means swimming will just about work too

Next problem is driving. Will I be restricted to auto boxes. Not such a problem as the Maser I was going for has the flippy floppy gear box but the Scimi Special I am building will be three pedals. I can drive an auto with nh left foot so should be okay.

So basically it is just wait for the cast to come off and carry on as normal. what could possibly go wrong?

Result

Hi Nick. I had something similar happen to me about 20 years ago. I was a front seat passenger in a car when we smashed into the corner of a bridge at about 50 mph and the impact smashed my right ankle and heel. I too was told it would need to be fused but decided against this and undertook about 6 months of regular hard physio. It was difficult but got there and remember it was tough basically bed bound for weeks then in a wheelchair then finally crutches before walking again. I suggest not focusing on the fusing part and concentrating on getting well again. Speedy recovery.

Can it only be mended using a cast?

I had a comminuted fracture of the distal tibia (just above the ankle) in 2000. I was 80% of the way to amputation of my left foot but a brilliant surgeon fitted an Ilizarov device and 6 months later I was back to walking about and 12 years on I am ‘normal’ and have no metalwork in my leg.

Basically the device is used to stabilise the fracture site by means of wires that are drilled through the bones, skewering the biggest bits if it’s smashed, and then tensioned and clamped either side to carbon fibre rings that go round your leg and are held apart using threaded bar.

You follow a program whereby you begin to weight-bear on crutches and gradually put more weight through your leg, which promotes the fracture site to become sticky and the bones begin to knit, until the point where you’re walking around and ready to have it removed.

See here for more info.

Best wishes & get well soon …stay +ve.

Nick, similar thing here smashed talus and calcaneum 15 years ago pins and plates in it, getting loads of pain now , at the time talk of amputation and fusion but now thinking could be fusion time but also you dont always lose the pain but you always lose the movement …..good luck with it
Oh drive an auto because of lack of left ankle movement

Yep, but mine is partial and naturally occurring, I have no side to side movement but some front to back. I was diagnosed about 20-25 years ago and at the time was told I had a 50% chance of it improving under an operation or it would worsen the situation.

If I stand for more than a couple of hours then its painful enough that I can’t walk properly the next morning, more than 4-5 miles walking will cause the same problems and can bring tears to my eyes when I get out of bed. It seems that because I have small bony growths in my ankle these crumble or break and then reset overnight in the wrong place if I’m not careful.

I started doing more sitting sports; I do a lot of kayaking and biking. I stopped using SPD’s as releasing was harder with the reduced movement in my ankle and modern flats/5:10’s are almost as grippy. Skiing is also ok for me as the boot contains and controls my foot, the fitter in France nearly fell off his stool when he saw the state of my feet though.

It’s manageable for me, I know my limitations and work within them or accept the consequences the next day. That said they are deteriorating now and I suspect I’m going to have to investigate an operation in the not too distant future.

Thanks for the extra feed back, it does help. I am definitely hoping to avoid the operation. The consultant said they had screwed and wired together all the bits of the talus that they could find but they was a lot of previous damage from last time I broke it and this impact was even more severe.

After the last crash seven years ago I was left with symptoms similar to mrhoppy. I asked at the time and was told I had the options: fuse, amputate or mtfu. I chose the later and hope to again. Interested in naranjadas experience and will investigate further. Just got to use the works slowest internet.

This is a scary thread as I am three months in after an operation on a broken tibia at the ankle joint. Broke leg in Jan found out about it an had op at end of June.

So far I am doing ok and have been able to do gentle rides but I am concerned I will end up in a bad state one day.

Glad to hear that you can still Ski ok mrhoppy as thats how I broke mine. And like you I’m not too bothered about not being able to use SPDs but it would be nice to have the option in a few months.

I’ve seen some pretty messed up ankles put back together with external fixation, maybe mention it to the dude the next time you’re in. If it was me, I’d look to try and avoid fusion for as long as possible.

Google Tom Staniford – he’s a real nice guy down in Exeter with two fused ankles (amongst other disabilities).

He’s on twitter too and quite chatty so I think he’ll be more than happy to dish out some advice and recommend where to go with stuff. He’s also sponsored by the guys at CycleFit so it’s likely they’re pretty experience with bike set up around those sort of injuries.

Good luck with it dude! Hope you keep riding.

Yes. Have a chum that broke his on the final assault course thingy to get his green beret. Ended up flying a desk instead and then had a very unpleasant outcome ~20 years later. I know very little of the detail but would suggest absolute last resort when every other option has been exhausted and verified by at least second and preferably third opinion.

Good luck 🙁

Tibia break stands a better chance of recovery for you l’ache hopefully. The trouble with a smashed talus is that I have destroyed the blood supply. This means the bone won’t ever grow back and the external frames won’t help.

I was told that I killed the blood supply last time I broke it so it is quite possible that my foot will be much the same as before. Strange to be hoping that I get as good as was last week when I was complaining about the ankle on thursday.

Oh well, all part of life’s rich tapestry.

Nick, not got a surgically fused one, but my right ankle is a huge mass of calcified stuff, with very limited movement.
walking uphill has to be done on my toes because it wont bend to the degree needed.
this happened after torn ligament damaged 20yrs ago playing rugby, and i never followed thru with my physio appointments.
so whatever you do, if it comes to it, make sure you go for your physio.

oh, and both my wrists are the same too, very limited movement and painfull in cold damp weather.
life is ace has you get older……………. 😆

@WCA – big thumbs up for your positive attitude, that’s going to count for a lot. Only thing I’d suggest is make sure you get multiple opinions, treatment options/thoughts can vary by country too.

Remember that to the NHS you’re considered cured if you leave the hospital alive and under your own power. That approach doesn’t suit any moderately active person – you may get a significant benefit from s private consultation.

Watch Gareth riding in Whistler.

Or you might remember his superb home-made cable cam video down the Beast

Gareth spiral fractured both ankles years ago in a climbing accident. I remember him describing the feeling later as having an ankle full of broken glass. He eventually had to have one fused and yet still played squash, skied seriously well, climbed well into the E grades and rode a bike better than most people here ever well (see the video).

Sadly, he died in a climbing accident in the middle of a year-long biking, climbing and skiing trip – but he was proof that fused ankles needn’t stop you doing anything you want.

Jamba / Flapper – I thought posting on STW was the approved method of getting a secondary consultation without needing private health. I will probably get a check from my private medical policy when I get our of here and before any further ops.

WCA where in country are you?

As you commented talus fractures are a different kettle of fish to a tibial plafond (articular) fracture. Type of talus fracture makes a big difference to outcome – Hawkins classification give you more info.

The big problem with any published outcome data/classifications though is they are only population trends – there is still variation.

As a general rule those who want to do well usually do in one fashion or another. Fusion would not be the end of the world if it needed to happen but depends how much function/pain you have when things settled down.

Not sure if that helps!

James

Can you not get ankle replacement surgery?

Jet – based in southampton

Glumpton – replacement ankles are not great at the moment and wear out quite quickly. Fitting a replacement uses up quite a bit of the remaining ankles bone so doing a second replacement to correct the failure is difficult

Mick Doohan won the 500cc World Championship 5 years running with a fused ankle. I think I remember he got his fused at a slightly greater (less acute) angle than usual, to be better suited to riding the motorcycle.

He was very big into getting racing advantage through fitness, so he got a lot of exercise of various types as well as riding race bikes. Might be worth googling his fitness regime/workouts.

Good luck!

Ten years ago my ankle looked a lot like yours did in that photo of yours recently posted on here.

Took a lot of work to get it back to something vaguely ankle shaped and it’s not been great since. I had remedial surgery on it last year to clean it out a bit which helped, but the eventual outcome for me has always been a fusion.

The official line from the surgeon is that when it’s time for the fusion we’ll know because I’ll be going to him and asking for it.

Knowing this, a few years ago I asked the advice of a motorcyclist who had had a fused ankle after years of pain post injury – he said opting for the fusion was the best decision he ever made and he wished he’d had it done sooner.

He was happy that he could ride his Harley again, and said the most issues he had was when walking and coming across a side slope. Not great for those of us who like being away from level tarmac, or for those who live in hilly areas, but for him a small price to pay to be pain free.

But all advice is obviously to be taken with a pinch of salt as it’s only as relevant as you think it is really. Everyone is different, has different injuries, different pain thresholds and different expectations from life, so like for like comparisons are not really much use.

Whatever happens, sorry to hear of the injury and best of luck with your recovery.

Nick, the blood supply to the talus is the key if the blood supply is compromised then thats where you have the problems, mine feels like walking round with a red hot poker in the ankle joint, what i found important was getting rid of as much scar tissue as you can, wierd having constant pain would be strange not having the pain anymore
Hope you stay positive I am sure you will work round it

My Dad got an ankle replacement instead of getting it fused.

Voodoo – blood supply was compromised after the last injury. Started to feel like walikng with hot coals in the ankle. Had an arthoscopy which helped massively. After about five years it started getting worse. I was just looking at getting so fresh physio arranged for next thursday when I went and broke it again.

I know that exact feeling Nick,if yours is like mine the extreme pain and swelling comes on for no reason ……any damage to blood supply to talus shows well within 3 months so your last injury would of reard its ugly head by now ….you will be good

First arthoscopy was a month after the original injury.
When I asked for another I was told either mtfu, fuse the joint or amputate.
I chose mtfu and I hope I can do the same again

Keep it moving Nick, they will probably do some remedial work whilst in there may turn out better for you ….keep positive mate and pat a few nurses bums! !

Jo @ Rideability has something like that, not sure if its is a fused one but basically has zero movement in his right ankle. You can see here the loss of his right calf muscle:

(He’s the chap underneath!).

… and he can seriously ride a bike (as you would hope for a MTB instructor).

HTH