Ankle Surgery - will it ever be right again?

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    Sep 08, 2007 3:21 PM GMT
    I'm looking for any support from people who have had ankle surgery. How well did you recover? Did you return to normal?

    My MRI and xrays show I have a congenital defect in my right ankle. There is a fibro-cartlaginous connection (a coalition) between my Calcaneous ( Heel) bone and Tarsus ( the hinge). These should move around on top of each other to allow movement, but my movement is restricted.

    So at this point there is only about 1.5 mm of cushion between two bones that should have 4 mm of space and that's not enough so the bones are knocking together and swelling. Then there is pain and inflamation in the tendons, bone and ligaments.

    Doc suggested orthotics which will limit side to side movement and recomments no doing activities what have side to side stopping or motions. I think that includes things like football, tennis, basketball, soccer, etc. Neutral - forward/backward - movements like walking, running or cycling would be ok - although there still might be some pain - they would be less likely to result in inflamation.

    If it continues to get worse - it could eventually be treated by fusing the two bones together.

    I'm thinking I'd rather have the surgery - cut out the coalition. Doc says the recovery from this procedure is good to very good. Getting that coalition out will result in more natural movement and reduce the chance that the bones are going to be pinching in the same spot, but rather gliding and putting the force/friction over a larger section of bone.

    Anyone else have there ankle go under the knife? How did it go? Pleased with the results?

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    Sep 08, 2007 10:20 PM GMT
    No experience with that, but if you haven't already, be sure to get a second opinion. Every surgeon I've ever talked with is eager to dive in and cut something, and let somebody else worry about quality-of-life issues.
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    Sep 08, 2007 10:36 PM GMT

    Every surgery is different, because people are different.

    I went under the knife 14 years ago after much more extensive and traumatic traumatic injuries.

    There have been almost unbelievably huge advances since then.

    Mindgarden is right, if you are worried get a second opinion.


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    Sep 09, 2007 5:47 AM GMT
    Mindgarden and IT Jock, thanks for your replies.

    (Sorry about some typos above - my 4yr old was harassing me about helping him build something in the garage. Right now, right now!)

    I have already seen another podiatrist 4 years ago. He recommended surgery. I thought he was too eager to go to the knife. He did not have good bedside manner - so he didn't engender alot of trust - although he was considered an excellent surgeon. I ended up retraining my gait to reduce pain and did not get surgery at that time.

    But now I'm interested in being more physically active. I'm cycling and running regularly.

    The podiatrist I'm talking to now works for the Health Center that I manage the computers for. So he's got to maintain a relationship with me after the surgery. Especially if he wants his computer systems to work. >:P I've worked with him over the last year. We have a good relationship. (It doesn't hurt that he's f-ing gorgeous).

    He's suggesting Orthotic Shoe inserts to minimize side to side movement of my foot. I pointed out that this still doesn't address the fibrous connection which holds the bones in place and prevents normal range of motion. The condition also PROMOTES bone stress and inflamation in the area.

    He agreed that I would have to live with the limitations on movement - and avoid activities that required that side to side movement using shoe inserts.

    I'm pushing for surgery, because I don't want to have the ankle deteriorate further, I don't want limitations. He is willing to do the surgery, if I'm not going to be happy with the limitations he's describing.

    This condition will not self-correct.

    I don't feel I need another Doctor's opinion, I want patient opinions about how the healing went for them. If I can't get feedback from RJ community - then I'll have to ask the Doctor for patient referrals so I can hear it from people who had to live with the results.

    Hopefully someone out there has had this, its not suppose to be too uncommon.
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    Sep 09, 2007 8:40 AM GMT

    Well in my case the pieces were in literally dozens of parts, and all the kings horses, and all the kings men couldn't put humpty dumpty back in OEM condition again.

    My balance is for shit on anything approaching uneven ground, and the pain is lifelong.

    You learn to adjust and get on with what you want to do.

    Am I as good as I was before - No. Am I going to be able to dance Swan Lake anytime soon - No; but then I couldn't dance swan lake before the accident either.

    You can only ask the docs to do their best, and the rest you have to live with.

    I also had spinal injuries that they said would prevent me from ever walking again. I refused to give in, and was in a wheelchair for 3+ years. While I was in that wheelchair I finished two college degrees, went through a dozen orthopedic operations, and eventually fought my way out of the chair by shere willpoweer.

    Sometimes you just have to suck it up and deal - and just get on with life.

    Whatever happens to your ankle - the question is:

    Are you going to let it change who you are, what you think is important, and what you do with your life?

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    Sep 10, 2007 4:04 AM GMT
    I have not known anyone who has gone under the knife for ankle issues, as runners. However, you're describing a situation in which your hoping to do activities that involve side-to-side motions. I'll defer to others who know about that.

    But orthotics CAN and DO help you to run with a neutral foot plant. I encourage you to try that, and to keep up the weight training. It's clearly working!! :-)
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    Sep 10, 2007 11:38 PM GMT
    The former RJ Member NYCMuscForMusc had this advice for OHiker. I'll rescind my previous post on orthotics, since this is NYC's area of expertise:

    "...(OHiker) has a very rare form of condition, a kind of Talus Coalition. This condition is ONLY corrected by resection and interoplation surgery, AND it has to be done fast, otherwise the fibirous connection will calcify and turn into a bone connect, and you anke will fuse!

    Orthotics will make this condition WORSE! PT will make it worse! The associated flat feet with talocancaneal coalition is actually a corrective mechanism by the body to avoid further trauma to the subtalor joint. That is why these runner get something called a spastic peroneous flat feet. Try to restor otherwise normal gait pattern on these kind of feet will increase pain and trauma to the ankle joint...."

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    Sep 11, 2007 3:29 AM GMT
    IT Jock - I not givin' up. I just need to get this fixed and be patient with the healing process. My situation doesn't sound as bad as what you faced.

    FastProf - Thanks for sharing NYC's words. We've emailed extensively on the subject and he's been very helpful. He's had me reading up on the issues and now I have some more questions for my Podiatrist.

    I think the surgery is my only real option - it's good to hear that it has positive results.
    Here's a story -
    My condition is congenital, so I went to my Grandma asking her if she knew anyone in the family with ankle problems. Her blind eyes almost opened and her eyebrows shot up and she said rather pointedly, 'ME!'.

    She then went on to tell about having swollen ankles all through her teen years. When she lived alone raising her three girls in the 1940's, her ankles hurt so bad she couldn't walk up stairs, but scooted up them.

    If she forgot to lock the doors when she laid down upstairs to sleep, she didn't bother - it was too much trouble to go down and lock them.
    She's always been a thin lady and short - bet she's never seen north of 100 lbs. If she had that much trouble being a thin little thing - its a good thing she never put on weight!

    She's always had health problems - 20 major surgeries in her life - yet she outlived all eight of her siblings. When I told her about my ankle - she smiled and said, 'We can't all be perfect." It was her friendly way of saying shut the f--- up, you don't know what health problems are, young'n.