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Ankle fusion vs. replacement

23-Oct-2013 02:05 PM

tlbzland

tlbzland
Posts: 6

Dr J - I thought about adding this to my previous talus fracture post, but I'm thinking it's a broader issue that deserves it's own discussion. So I got lucky with my talus fracture and should make a full recovery (if I can just sort out lingering soft tissues issues). But back when I didn't know how it was going to turn out, I spent some time looking into the worst case scenario - ankle FUBAR, at which point my surgeon said the best option would be an ankle fusion. Given my outcome, I have great respect for his surgical skill, but the more I've talked to people, I have increasingly come to the conclusion that he's dead wrong about the ankle fusion. I haven't heard anything good about ankle fusions, but I've talked to two people who are very happy with their ankle replacements. Additionally, my PT said she would almost never recommend a fusion now that there are an increasing number of surgeons who are capable with replacements. So sounds like it's a fairly new procedure but can have good outcomes if you seek out the right specialist. I'm guessing mangled ankles are not uncommon in the climbing world, so thinking there are probably quite a few people out there who would be interested in your opinion. Hoping I've learned my lesson and will never be one of them...
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19-Jan-2014 09:52 PM

Old Goat

Old Goat
Posts: 1

Having been a climber for most of my life (approaching 72), I got my ankle fused about 8 years ago.  My orthopedic surgeon is also a climber.  He discouraged my getting an ankle replacement because I am so active.  Replacements are not recommended for those who are  active and failure can have drastic consequences.

I am still a (volunteer) wilderness ranger at Mt Rainier.  Overall I am quite pleased with my fused ankle.  Most people do not even know I have one. One only looses partial mobility in the foot.

A fused ankle presents me with few limitations.  Twisting into a jam crack and side hill traverses with crampons on steep snow do present a problem. Obviously, I cannot lift my toe up or twist my whole foot, but there is some degree of torsion below the ankle.   My doctor does not want me parachuting or jumping from height.  However, these would present a problem for an ankle replacement as well.  It is handy for front pointing.

The main down side was not being able to place ANY weight on my foot for 6 months and living with screws for the first year.

My main regret was waiting to get it done.

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20-Jan-2014 08:05 AM

tlbzland

tlbzland
Posts: 6


Thanks for the great info about your experience! Since my post above, I have gone to a podiatrist in town who has a very strong reputation. He explained that there are multiple types of fusions because there are multiple joints in the ankle. One's experience may vary greatly depending on which joint is fused. In my case (talus fracture), he said I'm lucky because if I ever have to get a fusion it's the best joint to have fused - less potential problems than with other joints.
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