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It tweaked my ankle a few years back and after a number of operations over a five year period it has been reasonably stable for the last 5 years up until last summer. Some in shoe orthotics, purchased and home made versions, haven't helped and nor have steroid injections so I am back off to the surgeon on Monday to discuss the options. It has been MRI'd, x-rayed and CT Scanned so Monday it the go / no go decision meeting.
The problem is that although the ankle, heel and back of the foot are all fused, the joints towards the front of the foot are becoming arthritic and not taking the weight evenly causing much pain.
The last discussion, while we waited for the CT and MRI was that he would remove the 5 or 6 bolts that are in there from previous operations and then cut the ankle off completely and bolt it back in place to the foot is straight and flat again. This should relieve the strain on the joints and thus reduce the pain. I don't fancy going back into a cast again and have a couple concerns about the operation that I thought I would share. x-rays available if you think it will help.
Concerns
1 - There is not enough structure left in the ankle to bolt anything to, so how will he secure the joint (the last surgeon said it was like trying to secure bolts into a bag of sand)
2 - How sure is he that he will get it flat and level and if he does, how long before it starts to collapse and move again?
Anything else I should check out or be concerned about?
I've got nothing helpful to say, but good luck. That sounds awful.
Yeah, it sucks. but never mind. I will probably post photos of the various stages, if I go through with the operation. I suspect they won't be photos of the actual operations as they seem fixated on using general aesthetic for those but I an do before and after shots if you like.
If it was easier to post pictures in there I could show you the x-ray sequences as I went from two bolts, to three, five, back to four and then up to six. I will if there are enough requests 🙂
I got nothing. Jeez man. I sincerely hope it works out. You're a proper nice fella and would be sad to see you spannered
This was meant to be a fun, or at least information gathering, thread. I don't need sympathy, although I thank you for it, as most stuff I do it self inflicted and well deserved. When asked how I did it and the story starts with "I was in a rush to buy a Maserati and..." I don't think sympathy is normally the first emotion.
Fair enough, get on with it then long John silver
Can I have your car?……………too soon? 😉
All the best though and I do sincerely hope it works if you go through with it, is this seriously the only option you have left?, what about bone grafts to adjust the position with stem cell treatment to aid recovery/bone growth and a nice fixed cast to wear while it all sets in the desired position?
Well unless it's an auto the car is bugger all use to him, so you may as well.
Although I'm sure he can carve some foot shaped thing with a chainsaw, but may lose an arm and not be able to change gear
I’m utterly here for the graphic X-rays and photos.
I won’t give sympathy but can offer a vague amount of empathy as I have a shit wrist with some metal in it but this is on a different scale.
It’s amazing what they can do these days so I hope it does well.
Anything else I should check out or be concerned about?
Your informed consent documentation
Success rates for these types of procedures
Second opinion
Third opinion
But good luck with it mate
Hicks dig scars I hear. And that operation will give you the oddest scar in my head...
If it would help at all I can ask my ex for some friendly advice. She is a well respected orthopaedic surgeon specializing in ankles so would know exactly what you might expect/ask for. Unfortunately she has emigrated to New Zealand! We are still in touch though so just ask if you did want another opinion. I am pretty sure she would be happy to help. PM me if you want.
If it would help at all I can ask my ex for some friendly advice. Unfortunately she has emigrated to New Zealand!
What kind of monster are you! 😜
I get that the thread title was probably tongue in cheek, but is a prosthetic foot actually an option, or is that only the last nuclear option before wheelchair?
Welshfarmer - thanks for the offer but I am guessing she will need better info that some photos of my x-rays.
Frustratingly Postimage is down so I can't get pictures from there. I will see what I can find on Googlepics
Injury impact + about 40 seconds - https://lh3.googleusercontent.com/pw/AP1GczM2iZYAvaIVoWBvvRstoNC8-PkJp2iULsvJ0Vn-EfXSO0pih8NoDf5S3Hri0KHl_4XR0zIllTQdhV6RaXqysS6271XHf9ueUbyDDcyOXgU8XWjYgWyJNFVnxUSRFfDVsvL8nq_2WO9A4EaIV2N4vcJSIA=w2560-h1920-s-no-gm?authuser=0
II + 50 seconds (you can see the light behind the foot as it is moving down my leg towards me) https://lh3.googleusercontent.com/pw/AP1GczM-x-BDjY6OP-umZmpNorujj5C3NlTLu0URvQEVa5hkikfzChPA4xDF9ty-YSgqHEgOIVCb_1PkWJ2BfQpTLS1UMds0wJSFu1kQwR9fqSvlc2DBsRhTF7VhgMmGMFF2bTjgsVYHGwkHiCAqvcJTqyDqyQ=w2560-h1920-s-no-gm?authuser=0
Side view once the ambulance crew arrives but before the stuck the neck brace on (incorrectly suspected neck fracture) - https://lh3.googleusercontent.com/pw/AP1GczPS6F6qgZJQ_2I87NkNhFxpQnxd4Qomv3Bc6NzOUZ_sghiE0DNq5qfPVVaKb1m_5sElGAQcVXSaqtd0qVXGJKkS_kc7PIpo2739rir8wsJK0l5Mcr2uRA1ThV0IV_CY5Wzw10VVd0xuUVp7wSC0ediijQ=w2560-h1920-s-no-gm?authuser=0
First time they unwrapped the dressigns post op - https://lh3.googleusercontent.com/pw/AP1GczMk9DZ2z1FLAh__d87f3qDKMvYAiImLYkht4Chgdu3jh-zcz0HXqFLliFf8wN6DbYYqsPirl7PByMpuf3r8gKcBK9gs7M7YKoAT3U13GY2qcX0vUlravA7BBNbDzD_SSMmh6sSCm5VFCrX9A6vCNm56gA=w2560-h1920-s-no-gm?authuser=0
Nurse removing the rotting skin fromt he ankle - https://lh3.googleusercontent.com/pw/AP1GczNgI49YjmRoA-wZzknDiz4lY2aOAyrEkCGWdiwT2bKpArk8ZQ4PcPCp4LTE8NMwVhDav29KqjNR25np486AauMsUPiej_IC9SGRzM_ViY1sSLV-HyMbgQzzpgGq27cRnQdW6Y2gHFdBOfbg5QJSAKEQSg=w640-h480-s-no-gm?authuser=0
Blurry pic of the thing they shoved inside toi clear some of the debris from inside the ankle when fitteing the extra 2 bolts- https://lh3.googleusercontent.com/pw/AP1GczOVTW2p42VWTX7wdmozOEJ7BroXoqqMKUZwI1RPZiKCm8DU3u4QOLICKrJcfrd4OTbcdeK3LXmLHfMNlFrO4C7Ce4L9hiAZOFGPGg9MCRSLkvCwZXVnWhxWB6S4lOLOXN1TY-EEWX9vvhZSKJkQIX4_9g=w2597-h1948-s-no-gm?authuser=0
Minor bleed out after one of theoperations - https://lh3.googleusercontent.com/pw/AP1GczOu93CCMznj91tQj0QbDtXl3UpB4XLpo4z81jq2qjsbUYCFac4rbWRRfGnCBXbPFoXzl42x3lFFXhPmR9IFwVm7lWIQ_6fiebkqZQluOmC1Yn-dIDxLSge5s5v4ngT02qFZHn9rmj1pLIZpfDd3qne5EA=w2597-h1948-s-no-gm?authuser=0
Up to six bolts, I seem to have lost the xray with just 5 - https://lh3.googleusercontent.com/pw/AP1GczO-8MCUNswebrINkXBAXYk8Bpx79KWlUMcSESpeIKUNwm1ZZMGBobab4bKTy5PRf-Au70fr6gINcWjVuly7dmqrIzzSeCk0-7QubVZ3C5ZYxYw7bIsGvW-H9jwD1jZmLuOdtx7KZkOfMjk63j3yyUl9QQ=w2597-h1948-s-no-gm?authuser=0
Incidental bike crash where I stubbed my toe at 20mph didn't help with the bone alignment in the foot - https://lh3.googleusercontent.com/pw/AP1GczMbgFISdk7V50Q9UPC-77sbzpcLUKgxx7MHX8GSmhn8QSZ-JsHELVbZoJSrbjgpS82Opxq7c3yHjOtpR8bcbQ4dbJNJWbXP5t_l4LdVFdjUA9prptvjz7riOhSeheiUfJ2R8ZwlHituZGgY1z52jzqIeQ=w2597-h1948-s-no-gm?authuser=0
Will you get a barbed wire tattoo around the scar?
Most of those are relatively old. here are a couple of recent ones. It is quite interesting to see changes as the joints close up and the bone positions move compares to the early ones.
What tthew said. At what point is actually saying that an above ankle removal and a prosthetic (Adam Hills on Last Leg style - he plays disability rugby union in his) is a better longer term option that trying to cobble stuff together?
Easy to say when it isn't my leg, and I'm sure your're mainly attached to it, but that's what i'd be asking.
Who ever asked for my car, yes you can have it. It is for sale right now 🙂
And yes to the other person, all of them are automatics except for the truck. I sold all my manual cats when i realised i couldn't heel and toe during gear shifts with a fixed ankle. I did master clutches shifts before that though and managed to drive from Southampton to Readihg with my right foot in a cast
🤷🏻♂️ my thought would be ‘get a second opinion’.
This isn’t to negate your current surgeon’s plan. A second opinion may offer another option, or reinforce this course of action being the most suitable one for you. It might also give an alternative assessment of likely outcome. Not that more data is always helpful in decisions.
are there any options to improve the bone structure? These would not be short term fixes, but depending on the vascularisation and causes of its ‘sand like’ structure could there be medicinal ways to improve the bone?
Best of luck!
I did come to the thread wondering if you were going to be doing some live streaming of using an angle grinder to cut some low level steel concrete reinforcement.
Jb weld an option here...
Bodged a lot of shit up with that stuff in the past.
Orthopaedic surgery too me is just bodging. Its not a slight its just fixing stuff best you can...
My surgeon was upset when I said I'm glad you didn't become a joiner...
Absolutely agree about 2nd opinions for almost any surgery. This guy is the second opinion but that is because the first one said a guided steroid injection is all that was needed and then proceeded to fail to be able to inject into the foot and broke the syringe in the process. no harm done but didn't fill me with confidence. I will be getting a second, second opinion after the Monday meeting when I have the detailed proposal for the operation.
I like changing gear manually, when I am driving 'in a spirited manner' as it is an extra level of control* over the speed and balance of the car, plus lovely when you get the perfectly timed downshift. The rest of the time an auto is just plain easier.
*yes, modern autos are better and they are used in all top end sports cars now.
If it's the Ortho department then they'll have pushed it around the consultants anyway, and if they're talking about a serious operation then you kind of know it's probably good advice, as they tend to love just using those guided injections under x-ray to push you away for another 12 months.
The reality these days is that they'll have taken the scans, will more than likely have then computed the best option, as i believe they use software these days to work out the surgery, i doubt they'll start doing it, work out they can't reattach the foot and make you an offer for your shoe collection 😂
Cars suck anyway, had my hip replaced late last year, left one, which means clutch control and over the years of hip damage i hated it, car failed its MoT, needed a new car ASAP and the only 3 options were all manual, and diesel, that was more painful than the operation, i had been dreaming of an automatic for nearly 5 years!
They do make replacement ankles now, is this not an option?
I sold all my manual cats
Enduring image. Good luck whatever happens.
Maybe a bottle of strong whisky or brandy to easy any pain
Replacement ankles are still not that structurally strong and I am not the most delicate of people so they are not a good option for me.
Same with amputation and prosthetics. They are so much improved now, but like alcohol free beer, they are still shit in comparison to the real thing. They swap the pain and stiffness of the current situation to a new world of issues and they are also bloody expensive.
Just had a quick google and found this going cheap. I wonder if it is worth buying anyway, just in case...
https://www.ebay.co.uk/itm/145603905275
😆
Wow - can only wish you luck.
Looking at all of that metalwork I can certainly see the logic in removing it and doing some sort of more controlled arthrodesis at a hopefully ‘forces even’ weight-bearing angle. I assume with some bone graft in there to promote decent healing? The limiting factor being there being sufficient healthy bone there to get a decent strong plate to hold it in place.
Given that presumably other options would be last resort stuff it sounds like a sensible plan to me. I agree a second opinion isn’t a bad plan but one can only assume that salvage surgeries like this would be discussed in detail by orthopaedic teams prior to discussing with you.
You have my sympathy, can't you voice your concerns directly to your consultant / surgeon?
BITD I was doing research on twisted ankles and American researchers would find volunteers who were about to have their foot amputed above the ankle, forcibly twist their ankle with a preset angle of rotation and then examine the damage of the freshly amputated ankle. I think they had to give up because some patients suffered with phantom limb pain...................
Blimey, best of luck with it WCA !
As above - outcomes for this procedure, both general and specific to that surgeon (I don't suppose anybody does loads of these but, y'know). Agree that a range of opinion might be sought - though as somebody said, they may well have discussed you in an MDT. Perhaps you could ask for a summary of that discussion? It's not a slight on the surgeon to ask for another opinion and they may offer some sensible names (nat. Orthopaedic Hospital's not far up the road). How long do they anticipate it "holding" for? How long until you return to even yr current mobility and how much better than that can you expect? How likely is catastrophic failure?
Presumably yr surgeon's planning a couple of hundredweight of bone cement to help anchor everything. That stuff can last years in other applications but an ankle's probably quite an extreme challenge for it. I guess it might buy time for the fix
You wouldn’t expect bone cement in this sort of surgery - that is just used to attach prosthetics eg hip replacements etc.
Frok what I can glean / assume this would be a matter of creating a clean cut, possibly removing any articular cartilage between inter-tarsal bones if necessary, possibly putting some bone graft in there harvested from elsewhere, then fixing with a plates or possibly bilateral plates. If it heals well should be stable in the long term.
How is your hopping?
andylc has it right with regard the the plan. Basically remove all the old metal debris and the make a clean cut to get it aligned properly. The Dr hasn't discussed boner grafts etc yet as he wanted to see what the CT and MRI scans reveals. this is all for Mondays conversation. I have the benefit of work paid private health so I should be able to get a 2nd opinion easily enough.
This thread is really useful for raising ideas and questions, like about bone grafts, that I hadn't thought of. Then of course I need to decide whether to have it done as soon as possible so I am off crutches by the summer or do I wait until September so I am only stuck on crutches during the bad weather season?
My tuppence worth is that I would be going for the Adam Hill prosthetic as it's a one -off. You'll be going back many times more before they fit you for a wooden box if you opt for another repair.
Besides it's an excuse for a chi-chi carbon-fibre and titanium part.
Good luck with whatever you chose and POIDH.
What shall I make this time, for beer and food transportation?
Well, I have just come back from seeing the surgeon and there is both good news and bad news.
Good News - My ankle and foot are too ****ed to be worth operating on
Bad News - No gruesome photos to spice up this thread
Apparently the askle fusion is good, solid and straight, contrary to what he initially thought. The problem is cause by pretty much every joint forward of there being either deformed, dislodged, arthritic or any combination thereof.
This means there is not point removing the bolts or chopping off and realigning the ankle. GOOD NEWS.
There is also only marginal benefit in addressing any of the individual joints in the foot. This is because they are all damaged to different degrees and they all affect each other so if he fixes one joint in one tow then the next joint down, or the toe next to it, gets more strain put through it and needs work to correct that.
The surgeons advice is to avoid surgery for as long as possible but get some custom orthotics made. I explained my experience with the last podiatrics (The service costs this much, we can sell you an insert fo this much, you need a 1cm heel lift which is this much and if you want and arch support we can do one for this much and we can add toe cushions for this much - why not look at the brochure while you wait to the the podiatrist for the 1st consultation) and that I would like to see a medical and not sales professional. He discretely recommended someone from outside of the medical group and I see this guy on Wednesday.
Hopefully I will have another positive update then.
Sounds like good news, hope the orthotics help.
@worldclassaccident the best orthotics I've had were from a little french fella in Tignes who did customised ski boot fittings. He did proper hand shaped custom fittings that helped me out no end (pre fusion surgery).
He's probably retired now but he was waaay better than standard custom footbeds.
That’s great news, you can crack on with the car now.
WCA if in north of England know a very good podiatrist. PM if want details. They work mainly out of Northallerton
My plan is to get the 3D foot scan and custom moulded insert done. I will try to get hold of the .STL file for the shoe insert so I can print my own but failing that I will take a mold of the original and just make a loan in silicon or cork for all my shoes.
I did this before out of cork and it was way more comfortable than the hard plastic one I was given at the time. I am sure the tech has moved on, and the prices upward, so it will be interesting to see what the new stuff is like. I will keep this thread updated with the options, the pictures & the prices where I can.
Sorry they are not chopping my foot off* but hopefully you lot will still find this thread of some use.
* I am really NOT sorry
Pfft! I was looking forward to photo's of improvised prosthetic feet that you'd fashioned out of carbon fibre, aircraft grade aluminium, bits of lolly sticks and some duct tape
Seriously, thats fantastic news!
LOL. Eating celery sticks and beetroot dip while I look at the pics.
Hmmm, carbon composite skeleton with clear silicon outer for the shoe inserts...might be a good excuse to buy another 3D printer as I sold the old one...silicon moulding isn't something I have done much of, that could be fun.
Yep, lots of positives feeling pretty happy
i quit smoking in preparation for the operation -= the anaesthetists don't like smokers - but now I am not being operated on, shall I start smoking again. Is that a good provocation to the STW crowd to have a thread of it's own 😉
I went to the Podieatrist and he did a 3D scan of my foot which he then sent to some place in Spain to have an orthotic (shoe insert) made up that exactly matches the shape of my foot to provide maximum support. He will then add a bit to the heel to raise that a little and a bit to the middle so I can rock my foot a little when I walk to mimic ankle movement.
That sounds great but I have to wait 3 weeks so I thought I would have a quick go at making my own.
Take a 3D scan of my foot? Well, I am sure a foot imprint in some dried flower Oasis foam is about the same.
[url= https://i.postimg.cc/3xR0Gkdx/Orthotic-1.jp g" target="_blank">https://i.postimg.cc/3xR0Gkdx/Orthotic-1.jp g"/> [/img][/url]
The bottom of this was lovely and smooth but I forgot to take a photo before using it for the cast and it got damaged removing the cast.
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Pour in the plaster of paris and leave overnight to fully harden.
[url= https://i.postimg.cc/2yQ9nH9h/Orthotic-2.jp g" target="_blank">https://i.postimg.cc/2yQ9nH9h/Orthotic-2.jp g"/> [/img][/url]
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Find some aluminium foil from the car build project to give a sealed, non-stick surface over the plaster
[url= https://i.postimg.cc/TwwT7bvK/Orthotic-3.jp g" target="_blank">https://i.postimg.cc/TwwT7bvK/Orthotic-3.jp g"/> [/img][/url]
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All neatly wrapped ready to layer carbon fibre and some stiffener and make the insole.
[url= https://i.postimg.cc/nhhjbXxt/Orthotic-4.jp g" target="_blank">https://i.postimg.cc/nhhjbXxt/Orthotic-4.jp g"/> [/img][/url]
Slightly off topic, but an old fella i cycle with was a farmer and got his right arm pretty much torn off in an accident with machinery
the surgeon who reattached it was a member of his squash club. A year later the farmer beat the surgeon in the club’s squash final using his reattached arm. Surgeon had mixed feelings about it apparently..
When I discussed doing this with the podiatrist yesterday, he actively encouraged me to try and then bring him what I had made to see if it was suitable or if there were bits he could add/remove to make it perfect. We also discussed making a silicon mould of the original once it arrives and then trying different materials in the mould to make the ideal composite insert.
The carbon layup is currently curing in my bespoke custom autclave.
[url= https://i.postimg.cc/nrtN8JVw/Orthotic-5.jp g" target="_blank">https://i.postimg.cc/nrtN8JVw/Orthotic-5.jp g"/> [/img][/url]
sweeeet
Slight change of plan when I realised the heating wasn't on. Now under a vacuum bag.
[url= https://i.postimg.cc/7PKyXzXT/Orthotic-6.jp g" target="_blank">https://i.postimg.cc/7PKyXzXT/Orthotic-6.jp g"/> [/img][/url]
which obviously pierced as soon as I pulled full vacuum but the patch is sort of holding and it is better than nothing
Adam Hills on Last Leg style – he plays disability rugby union in his
He plays rugby league. #pedant
So, no parrot then..? Norwegian Blue or otherwise...
Hope you hadn't ordered one in advance of the critical meeting.
The home made mould, didyou get a roll with it?
Sorry, not sorry!
The oasis is not far off the stuff the podiatrists used when making my sons shoe inserts. The moulds are sealed & when opened the material is soft but then hardens in air after a while.
Oasis is great for mould making as it gets more solid and holds its shape better when crushed but also allows you to crush it a lot. Most stuff either lets you crush it a lot and starts to fall apart or gives you great detail and solidity but doesn't crush. It is normally a bit too stiff for body parts such as faces and hands but seemed to work for the foot.
The carbon is loosely cut to size but still on the mould while it hardens overnight indoors on the radiator. hopefully updates tomorrow.
I have to say, I started reading this thread expecting to see the use of a Dremmel under the influence of extreme alcohol, and then became more convinced that WCA would, in an almost reverse Bicentennial Man style, start his journey to become more machine than man.
Glad to see we have stayed on the path of just using a shed to make high grade medical parts from leftovers.