Ankle Fusion

[Guest guest]

Has anyone ever had a fusion that wouldn't heal? I had my surgery 5

months ago. At my Dr. visit last month he thought everything looked

good except for a place on the inside of the ankle, but wanted to

check old x-rays to compare. And also give it another month.

Yesterday I went for my visit. The inside place is still not healing

and he has ordered an MRI. I am really scared. I was told there was

a 30-40% chance the surgery wouldn't work due to CMT, but that since

I am relatively young and otherwise healthy I could probably lower

that percentage to 10-20%. My doctor didn't really want to discuss

the next steps until after the MRI. I'm afraid he will want to do

another surgery. I don't know if I can handle that, I'm not really

over the first one yet. This is very depressing. Just when I

thought I would be getting to go to the final stage (starting back in

a shoe, etc.) I get this news instead. So anyway, I'm just wondering

if anyone has had a similar experience they could share with me.

[Guest guest]

the next step might be the air chamber thing. They use it

to help diabetics heal. The warm air from the chamber helps your

circulation and you heal. I will try to look up more

information for you.

I had ankle fusion, and you won't believe this. I healed

faster then a kid would heal. My doctor was very surprised.

So was I. I usually get the bad news. Maybe the warm water

bed I had helped my circulation??

[Guest guest]

Thank you . Any info you could give me on the air chamber would help.

I will ask my dr. about it next week. I think I'll try spending more time

in the hot tub. Maybe the warmth and jets will help with circulation. I've

also been trying to spend more time with my leg higher than my head for the

last couple of days. Not his suggestion, but mine. I'm starting to feel

like a bat!

[Guest guest]

Hi again , I found the name for the chamber. It is called

Wound Healing and Hyperbaric Medicine. UCLA has a chamber I am

sure other hospitals would too. I thought just the part of the

person that wouldn't heal would go into the chamber. But this

is a big room. <A HREF= " http://www.bol.ucla.edu/~mlieber/ " >The

UCLA Gonda Center for Wound Healing and Hyperbaric Medicine</A>.

It may not be the exact thing I saw on TV but its close.

[Guest guest]

Hi Connie:

I recently had an ankle fusion (9/02) because I took a fall that resulted in

tearing all the ligaments in my ankle and due to CMT my doctors (had 2nd

opinion) didn't feel that repairing them would work for a long term fix.

When I elected to have the fusion the first doctor told me there was a 40%

chance that the fusion wouldn't heal due to CMT. She wanted to put screws

thru the outside of the ankle and use a halo to start the healing process.

The second doctor said that due to the fact that I am relatively healthy

besides having CMT, that I don't smoke and am not diabetic, we could lower

the risk factor to 30% and if I would follow all of his instructions he felt

very positive about a successful fusion. Well, I had the surgery on Sept.

10, 2002, went home 4 days later in a hard cast, spent 3 weeks in bed. For

4 months I used a wheelchair and in the latter 6 weeks of that time period

started using a walker. In January he put me in an air cast with the walker

and 30% weight bearing. During this time I kept telling him at my monthly

visit that I could feel a " clicking " in the front of my ankle. He explained

that was just all the torn ligaments that he couldn't repair. This didn't

make much sense to me considering that I had fusion materials and two

titanium rods to hold everything in place. But, I liked and trusted my

doctor so I accepted his explanation. In February he told me to start

slowly trying to wean myself from the cast back to a shoe. When I tried to

do this the ankle swelled to the size of a softball and held a fever. When

I reported this at my next visit, he decided that he didn't like the way my

xray looked and that we should do a MRI. As you are probably guessing at

this point, the MRI revealed that the ankle had only healed approximately

30% in 5 months. The " clicking " I kept reporting was actually a place where

the fusion material (bone and marrow mix) had not adhered. At this point,

he is ready to try anything. So he orders an EBI bone stimulator for me

which I wore 10 hours a day for 60 days, and he allowed me to start water

and physical therapy ( my request) which I did 3 times a week for two

months. In April the xrays showed no improvement, but we both still held

out hope that it was too early for the new treatments to have shown benefit.

Then at my May visit the xrays still looked the same. That is when my

doctor recommended that we start all over by taking out the rods and fusion

and taking part of my hip bone to fuse with and using screws from the

outside. Since he had already talked to me about this procedure at my April

visit I had time to consider it and confer with my husband and other family

members. I declined the 2nd operation and am being fitted with KAFO braces

for both legs. These braces are a little different than your standard AFO,

they are made with fiberglass supports up each side of the leg and titanium

hinges at the ankle. They have a piece that goes under the foot, but

doesn't cover the back of the heal or go all the way to the end of the toes.

They assure me they are more comfortable and " livable " than the plastic

AFOs. We shall see.

I had orginially planned to have both ankles fused, but since the failure of

the first I don't feel that I could go thru that right now and I doubt I

could find a doctor who would take me on. But, I still think it is a good

idea. I would highly recommend that you ask for a bone stimulator from the

beginning of the healing period and push for p/t and water p/t as soon as

you are able. My doctor didn't feel that p/t would do any good for someone

with CMT. I felt he was wrong about that from the beginning. I have always

exercised, especially in the water, and I feel that it has helped to keep me

mobile and active. I wish I would have been more ademant about that from

the beginning. So, I guess, what I'm saying is that even tho I had a bad

experience I think it could work. I no longer have drop foot on the ankle

that had the fusion. When I tried to wear a shoe the concept worked great,

I just had the horrible swelling and fever. Would I ever try it again?

Yes, I probably will in a couple of years. Right now I need to lose the 30

pounds I put on in the past year and get my strength built back up before I

feel that it would be worth my effort. Good luck if you try it.