UKC

Has anyone had their ankle fused for one reason or another? Are you still able to climb, drive, or even walk 'fairly normally' etc.?

Background: Dislocated and broke my right ankle (talus bone) in a fall at Tdog in Jan 2012. 'Fixed' with two titanium screws. Non-weight bearing for 3 months. Learn to walk again. Back climbing 9 months post accident. Back leading 12 months post accident.

Skip forward to now: Still love climbing, being outdoors etc. do so most weeks. However, suffer from chronic but manageable pain (codeine, paracetamol, ibuprofen daily) linked to osteoarthritis and tightness of tendons and ligaments, due to a limited range of movement (both dorsi- and plantarflexion) in the ankle resulting from new bone growth (body's natural way of protecting a damaged/squished bone) surrounding the talus which interferes with the tibia.

Solution: After consultation with a new trauma/orthopedic specialist, I've been offered an operation to remove said bone growth to increase range of movement. HOWEVER, the op runs the risk of a pain increase due to increased pressure onto a small damaged section of the talus (not protected due to cartilage damage and development of arthritis). The risk then is that then the pain may become unmanageable (unable to walk) and either take v. strong pain meds (no driving/generally be high 24/7) or have my ankle fused to stop/reduce pain back to manageable levels.

So my question is to those with a fused ankle, if I decided to go ahead with said operation, and end up (worse case scenario) having my ankle fused (going from <10 degrees of movement to 0) would I still be able to do the thing I love doing and climb/mountaineer still?

In reply to MikeStuart26:

I'll be interested in the replies to this, as my OH had a similar sounding accident 11 months ago. First (painful) lead about 6 months post-op. He is struggling with the pain (he's rubbish at taking painkillers) and limited movement, and is waiting to go back to the orthopaedic surgeons to see if they can improve things at all.

We have a friend who has a fused ankle (secondary to a car accident, not climbing) who has carried on climbing for years. The advantage is that it doesn't hurt. The disadvantage is that it's never at the right angle for what you want to do (walk uphill/downhill/across a slope). He walks pretty well on the flat, but slow on hills. I would be happier if he used walking poles. He is now limited by his knees.

In reply to MikeStuart26:

I remember read Joe Simpson mentioning mountaineering/ice climbing still being doable should he need to have a fused ankle.

In reply to MikeStuart26:

Only advise i can give, is wait for as long as you can before you fuse the ankle.

Medicine is finally making progress with regards ankles and cartilage after decades of not caring because there was more money in hips and knees, now that those are pretty much sorted and the market share is small the sights are being set on the ankles. The field of trauma and orthopaedics with regards ankles had stagnated since the 1980's.

There are some promising new technologies in the pipeline, and ankle replacements are advancing fast. Ankle transplants, though suffering from a high rate of failures at the moment, give excellent results for those that work. A hospital in the SE is already doing cartilage transplants that have been grown from the patient's own stem cells, and there's some materials research for a synthetic cartilage mesh that in early tests has performed very well.

In reply to MikeStuart26:

My friend had her ankle fused 2 years ago. She still climbs ok, only lower grade routes, but then thats all we ever climbed before her op anyway. No idea about winter stuff, for rock routes though theres not much difference. She does struggle on long walk ins though

In reply to MikeStuart26:

My friend had his ankle fused about 30 years ago, he continued to climb and lead lots of E4's and continues to climb now at a very respectable standard. He has had to modify his walking style which, over a long period, may have caused other issues, particularly with osteoarthritis in his knees, such that long mountain walks are no longer on the agenda.

In reply to MikeStuart26:

Broke my ankle years ago, had arthrodesis op twice in 3 years, been there done that, still able to climb .e3 .

In reply to MikeStuart26:

I did pretty much exactly the same as you in 2010

https://plus.google.com/photos?banner=pwa&pid=5982861816141687394&o...

All I can say as others have mentioned is stick with it as much as you can as even now I feel my ankle is still recovering and getting better.

Please pm me if you would like more info on my experiences or just a chat.

cheers

Gaz

In reply to MikeStuart26:

Simply bite the bullet and you'll get better. Don't go with the fusion, they suggest it because it's the easiest for them.
Things improve.

In reply to hun:



This is my view on it too.

I had a radically displaced class 5 fracture of the calcanium and sub-talar joint in 2009 (groundfall), resulting in much metalwork. The talus was fractured too (microfractures). The pins and plates were removed in a second big op 2 years ago which also removed as much as possible of the new bone growth which was causing impingement. I still have major pain issues due to joint osteoarthritis, calcification of tendons/ligaments and general stiffness. My surgeon now wants to fuse both the sub-talar and talar joints in order to reduce - or hopefully eliminate - the pain. However, I have major concerns, like you, re. the implications of such a procedure.

I'm a bloody minded, determined b@stard and I'm hard on myself. I've got used to being in constant pain and even when it becomes acute, I only use Voltarol (and cocodamol extremely rarely.) I strap up my ankle before walking/ climbing because the extra support really works for me, with less pain both during and especially after.

The thing is, nearly 5 years after my accident, it's still getting better - which may be partly due to better management on my part. I can still climb E3/ WI5 and if I was a better climber, I could probably climb even harder.

IMHO, hold off on the fusion for as long as you can (which might be forever!) That's what I've decided to do.

Good luck.

Dave

In reply to Mr Lopez:

Aye, waiting is my current train of thought after the surgeon told me all the risks involved, especially as I'm only 21 and at Uni for at least another year etc. (away from my consultant/surgeon). It turned out to not be the quick fix I hoped when I got refereed to the trauma specialist.

He also was talking about how medicine will (hopefully) play catch up regarding ankles: stem cells, ankle replacements etc. which is encouraging, I guess I'll have to be patient and wait.

- Becky E: even now I find I can't always get my ankle to what I want it do, but its good to know it doesn't cause pain. I already use poles whenever I go outdoors, it takes some weight off the ankle.

- Big Steve: I'm not surprised she struggles with long walk ins, I do too, I've become a bit of a roadside cragger.

- tmawer: I wish I could lead E4 in general

In reply to Melok:

Mind me asking why you had the arthrodesis op twice? Did the first fuse not work? How long was the recovery time after the op?

In reply to Gazlynn:

I presume them you have not had your ankle fused?

The reason I was looking at other options, inc. ankle fusion, was because I feel I've reached a plateau of what I can and can't do. My physio has got me to do as much as I can but its the physical problem of the bone growth that causes all the problems.

In reply to hun:

Aye the surgeon I saw did seem pretty keen for me to go ahead with it, until I mentioned how active and how much I still love to climb etc.



Thank you everyone else, its reassuring to know that if I went down the op route in a few years time and it went tits up and had to have my ankle fused that I could still climb.

In reply to Gazlynn:

I too had a similar fracture in the talus, I was in a lot of pain for maybe two years. Its been about 6 years since the accident and I too still feel it is recovering. For the painful two years I had no movement, but since then it is slowly coming back (no where near to what it should be).

My climbing style changed by stopping bouldering and trying safer harder routes. I am climbing harder now than I ever was.

Long walk ins are a killer, so I use sticks and that has made a massive difference.

I was advised that I could get surgery to clean it out or fuse it. I have heard too many bad stories of this going wrong so I have carried on with the pain. My advice would be just to keep trucking on for as long as possible and see what happens, surgery is always going to be a big risk. Just keep an eye on the rest of your body as it will try to compensate for the limp...

I hope that was helpful and gives you hope.

Cheers,
Mike

In reply to MikeStuart26:

hi ,i have just shattered my ankle on quite a bad fall didnt deck out but when i landed on my head and spun round my ankle caught a bit of rock sticking out , have had to have a external fixture frame fitted told for about 5months ,and after that i shouldnt climb for another 18-24 mnths due to the possibility of impact on my ankle , they are even being a bit finnicky about cycling after the frame has come off,after reading some of replies on here it looks like kayaking may be my next sport.

In reply to Dave Williams:

Sounds a nasty deck out!

I too have got used to the pain, I've just channeled it out into the background (constant L2 pain), with it occasionally getting the best of me when I have bad days or after a few active days climbing etc.

I'm curious as to how and what you strap your ankle up with? Do you strap it up to immobilise it completely or?

In what respect is it getting better? A reduction in pain and/or an increase of mobility/flexibility?

After the consultation I was discussing the pros and cons of having the bone growth removed via an op with my parents, and I came to conclusion that it seems that the risk far outweigh the potential gains of increased movement. The fusion isn't my first option, it would only be because of a complications in the prior operation.

So yeah, at least at the moment I think I'm going to hold off from the operation to remove the bone growth as the risk of fusion is too high.

Cheers!

In reply to MikeStuart26:



No I haven't had my ankle fused but there has been some natural fusion due to the healing process.

Sorry to keep repeating myself but you sound like me. I was going back to the specialist every few months and they where very pleased with how things where progressing and healing, I on the other hand was devastated as I was in pain every morning never mind any long walk or climb. Painkillers and the likes had very little effect on me and was getting depressed with the whole situation.
I can't remember the amount of appointments I have had with different professionals I've had MRI scan after MRI scan had operations to take out the titanium screws which didn't change anything much but I was just desperate to get and feel better. In the end the doctors told me that there wasn't anything else they could do and that they will be successfully doing ankle replacement operations in 10 years and I would be on the list.

Time is a great healer and it is so refreshing to see the likes of fellow posters and ankle smashers like Dave Williams who helped me greatly with his knowledge continue to get better as I remember some of his earlier posts on this subject being quite dark and depressing.

Everyone is different but I would give it time.

You are a fit young man with much better healing powers than a fat middle aged punter like myself

cheers

Gaz

In reply to squirrel00:

I get the no climbing (high impact sport) but i'm surprised they're being weird about cycling; have you not seen Joe Beaumont?
http://www.joebeaumont.com/

Just be careful with kayaking, I whitewater kayak up to grade 3/3+, as if you end up swimming down a rapid there are lots of rocks to get bashed around on. I was kayaking in the Alps last year and I got a bit of a battering when I had a few swims (I haven't got a perfect role) - fortunately I was okay.

In reply to MikeStuart26:
Hi Mike. I shattered my ankle in 2008. My surgeon recommended that I had my ankle fused as he said it was the worst break he had seen - gulp! It was too bad for any screws so I had an external fixator for 6 months! Pic here - https://www.facebook.com/photo.php?fbid=26286660981&set=a.26286070981.34214...

Like you I have a limited range of movement and walking for an hour does hurt. It does hurt everyday, but I just have to manage it. It seems most of us with bad ankles don't want it fused as lack of movement would impinge on climbing. I certainly wouldn't rush into the decision. I believe your pain should reduce so give it longer.

All the best

Graham

In reply to MikeStuart26:

Only 3m but directly onto solid rock. 7 weeks in hospital and a 10 month recovery/ rehab during really good summer and winter climbing weather. Was I peed off?!

Exactly the same for me. The pain's constant, even when sitting down and never less than L2-3, but in the background now, same as you. I find managing a week's constant climbing, with longish walk-ins, a bit of a challenge but I've successfully done it over the last couple of years. I use poles all the time now.

I use horse vetwrap, a cohesive bandage which is lighter (and cheaper) than the human variety. Also, it comes in a range of great, lurid colours. I don't over support my ankle and often have to adjust the bandage if it's too tight or not tight enough. You can buy vetwrap from equine stores or fleabay. I wrap it as for a sprained ankle, starting on the arch, under the ball of the foot, then a fig. of 8 round the ankle but usually only once round as that gives me just enough support and stability.

The latter. The more I ignore the pain and use it, the more mobile it becomes. I find that long walks in loose wellies give it a real workout and over time the resultant self-manipulation has been quite beneficial.

I decided, on balance to take that risk with a second op. It did work for me as I ended up with increased mobility and a bit less pain too.

Yes, you know your body; just do what feels right for you.

In reply to Gazlynn:


That's really great to know Gaz and I'm glad I was of some help. I did go through a bad patch and was getting some pretty poor medical advice at the time too. Eg. At one stage, when I could only walk about 1/2 mile, I complained to my GP about it, hoping that he's have some positive suggestions. The only advice that the idiot could give me was to forget walking and use the car more!

Luckily though my persistence paid off and I was eventually referred to a sports injury ankle trauma specialist at the Robert Jones & Agnes Hunt Orthopaedic Hospital in Oswestry. He's been excellent and basically, I haven't looked back since.

Hope yours continues to improve. PM me if you want a 'sgwrs fach'.

Hwyl

Dave

In reply to squirrel00:

Hi There
I’ve got a similar storey 8 years ago I smashed my ankle up. Many fractures ,a frame for 7 months, screws removed after 2 years, clean up surgery about 4 years ago and that helped make a fare bite of difference. I’ve ben climbing regularly ever since. I’ve lost a lot of confidence leading but can still second tope rope up to e3 5c. I have always got pain in the ankle but I’ve learnt to manage and live with it. I very rarely take pain killers because I am worried of the long term damage taking painkillers can do to you. My ankle is playing up at the moment and I am thinking of going back to the docs to see if there is any more excess bone growth occurring. I kayak myself to a good standard and the only time it bothers me kayaking is when I have to carry my boat, portage drops or chase my boat down the bank if I swim. Good to hear other peoples stores and share experience and advice. I’ve though about ankle fusion but like everyone else it’s my last option if the pain become unbearable. I found the first 24 months hard but things did get better

In reply to MikeStuart26:
I've been in pretty much the same boat, having suffered an almost identical injury and then having to discuss ankle fusion as a possible solution.

I didn't need it in the end, and am mighty glad about that. But it was close run.

My first piece of advice is to hang in there - arthrodesis is, necessarily, irreversible and is a salvage procedure, not a treatment. My pain and general discomfort were at their worst for about two years, with a gradual improvement over another four to a plateau which has persisted.

I mainlined brufen for a couple of years, and had pain both during exercise and, classically, the morning after (pain after rest after exercise is a hallmark of arthritis). But gradually, things levelled off. I still get pain at the end of prolonged exercise, and if I have a heavy day, it takes a while the next morning to get any kind of movement in the joint, but it takes care of itself without the need for analgesics.

If that sounds a bit bleak, it really isn't. I can't think of anything I haven't been able to do because if it. And a year on crutches turned me into a Beast.

I'm waffling a bit, but I'd hold off on the arthrodesis - and only your consultant can properly inform you on the degree of risk that the bone-shaving op will entail in terms of then needing fusion. My own experience was that, at the point in time you're at now, things started to improve in any case. It's a complex thing, and everybody heals differently, but Dr Time is a great healer.

Happy to discuss it further if you want.

Martin

Edit: my injury was about 25 years ago, so whilst people like Dave and Gaz are giving you excellent, up to date info, I can only really comment on general impact over nearly three decades.

In reply to MikeStuart26:

Back in 86, bad break, compound fracture (spiral break).lost 4inches on bottom of fibia, only got the tibia bone.1 yr on after op.had to push on, (tremadog) picked a fine route (spare rib), led first pitch, painful.following year, arthritis pretty bad, no good , had to second op, am I boring you. Recovery time 2 weeks foot elevated , 3 months on crutches, walking stick 2yrs, try rid the limp eventually. Hey last week did ( last tango ) vivian quarry with my son.

In reply to bud the dog:

4yrs ago same problem, last option , top doc, quartazone injection ankle core, but no way in all the windows were shut,excess bone growth.

In reply to squirrel00:

I have a Taylor spatial frame fitted and cycle everyday. Only person who had an issue with it was my first physio, whom received a big fat middle finger when he suggested i stopped doing it. Current physio actually encourages me to do as much exercise as i can, specially cycling.

In reply to all:

Vary encouraged by what I'm reading here - I will point my OH at it. Thank you all.

In reply to MikeStuart26:

Had a very small fracture in talus & calcaneus in 2009. Did quite a bit of damage to the subtalar joint. Had a few minor ops over the first 3 years, mainly aimed at trying to improve mobility.

Over the last couple of years it seems to have settled down a bit. Still arthritic and stiff when starting off on things. After hammering it a bit I'll be hanging on to the furniture to move around the room, but not much pain unless weight bearing. Once it's moving it seems to hold up. Working on trying some bigger days in due course.

I wasn't a great climber anyway (best lead HS4b) but while overall it is certainly worse than it was 3 years ago I can do more with it.

Mike - at 21 you should repair better than those who are older. I'd keep options open: if heading towards fusion or you find you can't do as much as you want then it might be worth trying the debridement as a first step, but from my experience I would say that it is worth seeing how it develops over a few years. Other posts here suggest that these things can continue to improve for 5 years or more.

In reply to MikeStuart26:

Fused right ankle: Driving fine as you get used to lifting your whole leg to brake. You still have movement between your heel and foot.
Climbing more of a problem as jumping off not very pleasant and swinging in after a leader fall nasty as your have no shock absorption.
Spent 10 years in pain prior to the op, just wish I'd had it done sooner.
Mountain biking has replaced climbing for me; need clip pedals though.

In reply to MikeStuart26:

I broke my ankle very badly in an ice climbing fall 20 years ago. I have not been able to do anything involving running since but have continued to walk, cycle, ski and climb (rock, ice and Alpine) since.
It continued to improve after the initial surgery for a few years and then plateaud for about 10 during which I only needed ibuprofen occasionally.
It then deteriorated over the next 4 or 5 years during which I had to increase my use of ibuprofen to the point where I was on maximum dose all the time. (NEVER take ibuprofen on an empty stomach, long term use can cause a lot of stomach problems).

I had an arthroscopic debridement to clean up the damaged cartilage which made the pain worse (quite common) and as a last resort had a steroid injection (which got me through a mountaineering trip to Peru) but it only worked for 3 months, after that I couldn't even walk in to Stanage without trekking poles and getting my mate to carry all the gear. Once you get to the stage of needing steroid imjections you've pretty much come to the end of the road as far as the joint is concerned. If you're lucky they might be effective for 6 months but you can only have 2 or 3 before they stop working. At that point fusion is about the only option at the moment. Replacement joints wear out very quickly if you're active, potentially in under 5 years and you can't have them redone yet like you can with hips and knees. They rarely give them to anyone under 60.

I had my ankle fused 3 years ago, I can still drive as normal and it has no effect on my climbing (I had virtually lost all the movement in the joint anyway). I went skiing this winter, with a modified boot, and have done a bit of winter climbing. The problem I have is walking any distance. I'm OK up to 5 or 6 miles but beyond that I need to take Ibuprofen.

Best case for a fusion is removal of all pain but I had complications, it didn't fuse properly and I had to have some ultrasound treatment to get it to fuse properly but this may be why I still have some pain.

As others have said, hang on as long as you can as things are developing and other treatments may come along. I saw a consultant privately to discuss options other than fusion. There are a few possibilties like using stem cells to grow new cartilage and transplanting it back into the joint but they're all a bit in the research stage, a bit expensive and in my case not possible as the damage was too bad by then.

I don't know which hospital you're being seen at but I'd thoroughly recommend trying Oswestry if you feel you want a second opinion or you're not happy with what you're being offered. Its not exactly near Aberystwyth but their catchment covers most of North Wales and anyway, you have a right to be referred to any hospital of your choice.
After my fusion failed I asked to be referred there as I'd heard a lot of good things about it and wish I'd done so before the fusion. Its a specialist orthopaedic hospital (one of only 2 I believe) and the difference between it and the other hospitals I've been to over the years is remarkable.
Good luck and if you want any more info just ask.

In reply to Dave Williams:


Was that Simon Hill? He saved me from having to have a second fusion op with an Ilizarov frame which was the nightmare scenario. Wish I'd seen him sooner.

In reply to MikeStuart26:

They reckon that there's a chance of impact when unclipping. At the lights, think they are doing a bit of arse covering to be fair, as for the kayaking was thinking about just some river touring, but I dare say that will change, same as I told wife I would only second when I get back climbing there's just no fun in it

In reply to bud the dog:

Cheers mate not really looking forward to the next 2yrs but as I landed head first I'm tending to look on the bright side of at least my kids don't have to push me around or feed me for the foreseeable future, hopefully some beginners kayaking should relieve the boredom

In reply to squirrel00:

Hi mate

Yep your write about what could of happen, I constantly remind myself that it could have been a lot worse to.

All the best with your recovery.

Loz

In reply to pec:

Hi Pec

thanks for your post it’s good to hear the experiences of youerself who has had to live with a dodgy ankle for 20 year’s. I think I might end up in a similar boat to what you’re in and your words are reassuring

thanks

laurie

In reply to Mr Lopez:

Izio or similar name frame I have, looks like a few horse shoes overlapped and bolted together with some sticks of threaded bar joining the 2 together

In reply to squirrel00:

I think that is the frame my daughter had on her leg to help fuse a smashed up tibia, she had to tweek the screw every day to pull the two parts of the bone apart. Still having problems with tendons - not sure she will ever climb anything serious again. She bounced down 1500ft of ice gully on MtShasta. But the movement of the joint does continue to improve with activity so never abandon hope!

In reply to altirando:

Yep thought climbing may be off the table but we'll see what happens when I get the frame off, only had this one a week had a delta frame for the previous week just to hold everything together, not giving up hope just need to start making plans so I have something to work towards, but really not looking forward to the actual removal from how the nurse described it,

In reply to squirrel00:

I didn’t find the removal of the frame that bad its over very quickly. Get yourself a finger board and get super strong on that! Are you under care at Sheffield?


Thanks
Loz

In reply to bud the dog:

No mate stoke trauma, great surgeons and nurses but couldn't organise the proverbial p@#s up in a brewery, just following instructions now and slightly weighting it for 10 min every hr by end of day it's agony, hopefully should be able to weight fully in the next month

In reply to MikeStuart26:

Hi Mike,

Sorry to hear about your predicament. I broke my ankle soloing in Cheddar about six years ago and sustained a Hawkins II fracture of the sub talar neck.

This was initially operated on in the RUH Bath. Annoyingly, it was set at a angle which meant I was constantly walking with a limp and putting pressure on the outside of my foot. It was a nightmare,

Luckily, I had a private health care policy through work, which enabled me to go to the London Foot and Ankle Clinic, where I had the injury re assessed and subsequently the joint fused.

I didn't have any movement before the fusion, so didn't feel like I had lost anything (in fact, being able to lay my foot flat on the floor after two years was amazing).

I can still climb (although cracks are harder now - no more sticking your toes in and cranking over on your ankle), ski and snowboard. I can also walk all day in the mountains with the best of them.

I do have quite a bit of pain in the winter, but this is manageable. Don't be led to believe that a fusion gets rid of all of this. I can cope without medication though (just have to get it warmed up first thing)

As per some of the other messages on here, happy to chat this through or help if I can.

tizer

In reply to MikeStuart26:

Friend of mine fractured his ankle and the talus bone never recovered. After about 2 years of pain, he chose a below-knee amputation over having his ankle fused, as he figured a fused ankle would limit him too much.

He now has a collection of artificial feet and, judging by his Facebook pictures, isn't holding back in the hills or oceans.

In reply to MikeStuart26: I know its extreme but what about amputation below the knee there are some very good prosthetics that would enable you to climb.

In reply to tizer:


Ditto, although the angle wasn't severe enough to make further procedures worthwhile. Oddly, it's meant that I can run perfectly well anti-clockwise (ie round a track), but not t'other way.

I'd be amazed if surgeons were willing to go for amputation rather than fusion: the latter is already a sub-optimal salvage procedure and the former actively disables the patient. It would have to be major, intractable pain to make the chop worthwhile.

Clearly, talus fracture is a Proper climber's injury: b*ll*cks to your A2 pulley strains

Martin

In reply to LastBoyScout:

That'll be my choice if the time comes and i don't bottle out at the last moment... Loads of people have taken that route, even post-fusion, and they are all happy with their choice and not looking back.

That brings a whole new world of problems, and it can get expensive, but at least the doors are left open to be able to run, jump, dealing with uneven ground, long treks, etc. Worth considering.

In reply to MikeStuart26:

Ive got a prosthetic leg below knee which has no ankle movement. I never climbed before getting injured but enjoy climbing mountaineering and winter climbing now.

I cant speak on behalf of how the pain will be having it fused, but you just learn to work around your injury.

In reply to Mr Lopez:

Wow! Really? Lose a leg rather than live with an ankle fusion? Things would have to be pretty bad for me to take that course of action. I was told it might have to come off if avascular necrosis set in, but the chance of that was reasonably low.

As I mentioned above, I can do almost everything I did before. I have the use of all my toes and some lateral movement around front of the foot.

How can a prosthetic be better than that?

In reply to tizer:
I know it sounds like a crazy 'idea', and there's from all of us an understandable and reasonable attachment to our bodies which make a decision like this sound like something that is absolutely nuts, and that was my line of thought when i first came across this option and choice people had made when researching what it would be like to live with a fused ankle.

After some time though, i decided this is something that should be assessed by its own merits in a cold hearted manner, and spent a very long time playing a game of top trumps with the 2 options, and in a cold hearted assessment and specifically for myself, letting go of the foot wins hands down, every time, no contest.

This is a very personal decision and the answer will be different for each person. What's best for me doesn't mean it's the best for someone else, so it would be fruitless and untactful of me to argue the merits and pitfalls of each with someone who is perfectly happy with his choice.

For me it's a matter of leaving the doors open to fulfil dreams and plans hatched a very long time ago, as well as leaving those doors open for a wider option of new ones to come. Doors a fusion will close forever, but a chop may just leave them a possibility.

I hope i never have to put my foot where my mouth is though, but since the odds are against me i have looked into it and that seems like the best outcome.

Cheers

In reply to Mr Lopez:
I've often wondered over the 20 years since I broke my ankle whether I'd have been better off having it amputated. It would have saved alot of hassle in many respects, I've had 6 operations, spent over a year on crutches (in total) and had pain to a greater or lesser extent almost everyday. But as you say, for some reason we have an emotional bond to our body parts and in practical terms I've continued to walk, climb (including ice and alpine), mountain bike and ski and now I've had it fused I continue to do all those things and having one less joint really doesn't make much difference, its only running I miss.
I understand that amputation is not without problems, ghost pain, pressure sores and the like and it must cause some practical difficulties, with a fused ankle I can still move all the other ankle and foot joints.
I know the fusion may accelerate wear and tear in the rest of my foot and if it comes to multiple fusions I may consider amputation but just as I put fusion off for as long as possible I think I'll do the same with amputation!

Regarding your dilema, if fusion doesn't work out you can still go for amputation but not the other way round.

In reply to MikeStuart26:

Hi Mike, firstly sorry to hear about your situation. But you're definitely not alone. In fact, I posted the very same question on this forum 2 years ago when I was weighing up my options. I had a really bad bouldering fall in 2008 (bone sticking out kind), long story short, I had 8 surgeries over a period of 2.5 years, had an external frame, had hard ware put in then taken out, had debriment of bone spurs to encourage dorxiflexion and plantarflexion - I only have a 5 degree movement range in the ankle, 5 years of intense physiotherapy 3 times a week. Nothing I did gave me more range of motion, I don't have any cartilage left in the joint and the joint has actually naturally fused over time - there is no gap between the fib and talus anymore due to no cartilage. The pain was unbearable for the first few years, but I had some stomach ulcer issues from relying on the pain killers and I made a decision to go drug free. I discovered that your mind is a powerful thing, pain is all in your brain. So I toughened up and just put up with it. I started climbing again when I was still on crutches, but was in hospital again when my partner had a long lead fall and I got dragged into the wall and put my feet out instinctively. I cannot do long approaches to crags, I climb a lot better than I walk, but I do go to my local bouldering gym twice a week now and am feeling as strong as I can be (given my delicate ankle and knees I try to down climb and not top-out at the bouldering gym). The ankle has settled down now after 6 years. The pain is manageable - and I just tell my self to toughen the F** up when its bothering me because I'm a climber and I'm not gonna let what happened to me define me. You will be amazed at how well you cope with the pain - but it is a learning process and it takes time. I too contemplated all available options, from fusion to ankle replacement to amputation, and I spent a long long time researching the pros and cons. But I held off on all of them. I felt that technology will continue to improve and the longer I hold off, the more and better the options would be for me when/if I ever decide to do something about it. It really is a daily challenge with the pain but my mind has learnt to block it out. Please get in touch with me if you want to share some pros and cons of all the available options. Personally for me, I'm glad I did not fuse or amputate yet. As you will have seen from this forum, there are plenty of climbers who still climb with damaged ankles/knees, so even if you decide to fuse, you will continue climbing because it is your passion.

In reply to MikeStuart26:

Mike, I had my ankle fused just over a year ago after smashing my Talus in 2010. I wish I hadn't bothered. In worse pain than ever, knees, hips and lower back suffering due to hefty limp and had to pretty much quit going to the mountains now. Seriously considering amputation if I can find a willing surgeon. Sorry to sound so bleak.

In reply to MikeStuart26:

Hi had my ankle fused 25 years ago after a climbing injury.
It probably reduces the height I am happy to jump from when bouldering, but a Moon Saturn largely fixes that.
I now one leg I can stand on all day without getting calf wobbles.
Only recently got back into climbing, but its really not a problem.

In reply to Kev Shields:

So sorry to hear that Kev. One suggestion i see quite often while lurking through forums, and which seems to have helped a lot of people in the same situation trying to be active, is a pair of these.

http://www.zcoil.com/shop/
http://www.zcoil.com/rocker-forefoot/

The 'reports' are that people can walk and hike with a natural gait and even run with them. Maybe a chat with a podiatrist and/or physio with kinematics experience so they could advise you if it's likely to help?

In reply to Mr Lopez:

Cheers dude, worth looking into! Though if I wore those in my home town my ankle would be the least of my worries