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Old 12-19-2012, 11:29 PM   #1
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Question Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Hey everyone, went to my orthopedic surgeon appointment today and finally got the answers i was looking for and found someone who i get along with and is apparently one of the best in my region

Basically what is going on is that i have total instability in my ankle hence all the clicking etc that i get and that my ATFL is partially torn my calcaneofibular ligament is possibly partially torn my AITFL ligament is part torn and my syndesmosis ligament is at least 80% torn and i have basically no instability in my ankle what so ever and apparently it just isn't healing as the healing process for it has ended and my bone isn't showing any signs of it healing.

So whats happening is he wants me to go in a cam walker boot for 6 weeks been told not to bother with it for bed as its pretty much too late for that with how unstable my ankle is and that its not healing due to the healing process ending without it ever being healed as apparently the bone around it doesn't show any signs of healing. The boot though is just to see if i can get a bit of stability back and to get my muscles in my leg working and a bit of the swelling down etc to prevent the risk of chronic regional pain syndrome happening cause of how my nerves etc are already stirred up from my injury as well as the blood flow being constricted from it too. If i am still unstable by my next appointment at the end of February then apparently he will go in and reconstruct it using a tendon from somewhere to allow my ankle to be stable again and we will discuss that then if the boot doesn't help with the stability.

However that brings me to a few questions where is the tendon taken from when they do a ankle reconstruction same for the ligament they would also use for reconstructing parts where the tendon wouldn't go? where do they get that from off me?

Secondly what exactly is done in an ankle reconstruction?

That's all for now but will ask more when i think of it other than that can people give me there stories on what happened for them with ankle reconstruction that was done using the tendons? Thanks

 
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Old 12-20-2012, 06:01 AM   #2
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Star, there are a bazillion posts on here that will answer most of your questions. Poke around a little bit on previous pages and you'll find folks in all stages of prep, pre-surgery, post surgery and recovery. Happy reading!
Ginger

 
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Old 12-20-2012, 06:17 AM   #3
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Thanks ginger will do was just wondering as he seems to think the boot wont work since the ankle no longer is showing any signs of healing and that was from 4 months ago so i would say this would be going ahead have no idea though why he asked me if i have back heel pain and big toe pain though both of which are a yes but oh well thanks for that good to know at least i am finally looking at it being all fixed up and no longer being in pain whenever i bend it too much etc am kinda looking forward to a normal life again and getting answers relieves so much stress thanks again will check it out very much appreciated know i will probably be nervous after he discusses the details with me though next appointment after trying the boot lol but all good thanks again

 
Old 12-20-2012, 02:06 PM   #4
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Hi Star, I'm 9 days post op from ankle reconstruction, My surgeon did a Chrisman-snook procedure. Replacement parts, as needed, were man made materials. My tendons/ligaments had been stretched too much to successfully used, due to numerous sprains, injuries to that ankle. There are different types of reconstruction, do you know the name of the procedure your surgeon is using? He also repaired ligaments by adding sutures, for additional strength. When you google, you can read how it's done. My dr had me in a short air cast for two months prior to surgery, no change in condition of ankle. This board is a great source of information and support. Please feel free to ask any questions,,,I'll do my best to help!

 
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Old 12-20-2012, 03:39 PM   #5
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Quote:
Originally Posted by Btrfli1 View Post
Hi Star, I'm 9 days post op from ankle reconstruction, My surgeon did a Chrisman-snook procedure. Replacement parts, as needed, were man made materials. My tendons/ligaments had been stretched too much to successfully used, due to numerous sprains, injuries to that ankle. There are different types of reconstruction, do you know the name of the procedure your surgeon is using? He also repaired ligaments by adding sutures, for additional strength. When you google, you can read how it's done. My dr had me in a short air cast for two months prior to surgery, no change in condition of ankle. This board is a great source of information and support. Please feel free to ask any questions,,,I'll do my best to help!
Hey Btrfli, No my surgeon hasn't told me details or about the procedure yet as even though he doesn't expect it to heal he does want me to get swelling down as well as build up some muscle tone and allow my nerves to be less sensitive from my injury as i already have a slightly numb patch on my foot due to the injury i also have some restricted blood supply cause of my injury too also he wants to prevent chronic regional pain syndrome too which apparently cause of the way my injury is at the moment i would be guaranteed to get which makes sense. All i know is that he mentioned reconstruction using a tendon cause apparently the other one is more likely to fail and apparently he will also use some other sort of ligament or ligaments to help repair the torn syndesmosis or something and i think he planned on putting something through the bones to also support the syndesmosis together as when i had stress x rays done they squeezed my leg bones together lol so he couldn't tell other than my MRI and his physical test what was going on.

He did seem very knowledgeable though and i still don't get why when he was looking at my CT scans which apparently were normal if i get pain in the back of my heal and my big toe which i do at times so i have no idea how he knew that when i hadn't told him but yes. Any Ideas? he also noticed in the MRI that my ankle is just going to be staying this way due to the fact that there are no signs of healing at all on the MRI around where i am injured and apparently i also have a very loose ankle and that's why i always get clunking. but he said not to worry about the boot full time with bed and that cause my ankle isn't healing and he just wants to get swelling etc down before we discuss what he wants to do in surgery.

some things i wanted to know though how invasive is this procedure? What else is done with it to allow the ankle reconstruction to take? How long are you NWB etc? How long does it take for them to do the procedure in theater? How did it work out for you Btrifi? Hope all is well on your front after surgery? Does this procedure really help? I was told there will be stiffness and i may have some aches and clicking and a little bit of pain due to this at the end of the day but that it would mean i can run etc again which i haven't done much for 3 years and would love to do. otherwise i will ask as i think of them.

Thanks

 
Old 12-20-2012, 05:15 PM   #6
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Hi Star, I don't know anything about the other issues he discussed with you, but as far as my procedure went, I was in surgery a little over two hours. I had nerve blocks, one into side of knee, one in ankle, deaden the surgery site, and was given general anesthesia, as well. Purpose of the nerve blocks is to keep you pain free, for a long period of time, post op. My surgery was at 730am, and the blocks began to wear off about 2 in the morning. I was given prescription of oral pain meds to take every 6 hrs, post op for pain relief. The first few days are rough. I had surgery on Tues and by Fri, was feeling better, stronger, etc. Everyone's exoperience is different, depends on what you have done, your general health, your pain tolerance levels, etc. My dr's post op plan was for me to be in a surgical splint, with dressing, for one week, NWB, with the foot elevated 23 hrs/day. First post op office visit was one week after surgery. At that appt, the dr removed dressing, checked wound, cleaned it, redressed wound and applied fiberglass cast to the knee. He wants me to remain NWB, elevated the same, for 10 more days. At that visit, I'll have sutures removed. I'll have another hard cast for two more weeks, Air cast boot for a month, WB as tolerated. If everything progresses as planned, PT will be start after that period. My dr feels this I'll have a great outcome,,,I'm not a runner, so that ability was not discussed. I don't know how it's gonna work out for me, too soon to tell. I would not have had this surgery if I wasn't confident of a full recovery. I believe you have to be patient and follow your dr's post op recovery schedule I'm order to have the best possible results.

 
Old 12-20-2012, 07:59 PM   #7
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

hey Btrifli, thanks for your response, yes am just finding out info at the moment about it first there is the boot then will see about that stuff with the reconstruction but am hoping it will go ahead don't think the boot will do anything but may as well try and see can i ask why you had an air cast for 2 months before you had surgery? and how did teh orthopedic doctor decide what you needed done? as i have no idea what he thinks needs doing other than the tendon transfer and some other stuff for the other damaged areas in my syndesmosis area etc. And no i am not really a runner either but one day i would like kids and would like to be able to run around and play with them just saying but yes have no idea how he knew about pains i was having from looking at my scans that i didn't mention but yes he also seemed to be able to tell a lot from my ankle scans as to what was going on with it which was nice to see and the fact that he was the first person to be able to tell me what was going on with my ankle after 3 + years of living with it so it was a nice change no one else i have seen has ever even known that before this guy so yes it was a good feeling thing that annoys me though is if all these people hadn't kept misdiagnosing me i wouldn't be in this situation of needing ankle reconstruction and he said if i had seen him first he would have had me in a cam boot constantly even for sleeping for 6 weeks. Now the cam boot is just so i can walk and reduce swelling etc so that he is able to operate and fix it up and also to see if the muscles can strengthen a bit and help with a very unstable ankle with clicking etc but i don't think this will totally fix it up as he said not worth bothering wearing it to bed or anything as its too late for that and he doubts with no signs of my ankle healing that it will ever heal but good thing is there is now light at the end of the tunnel and i may be able to finally get off my butt and live life lol though he did warn me the tendon transfer would be stiff and i would probably get some clicking and a bit of aches and pains from it but i think to be able to do things again i am willing to live with that and if it means my ankle no longer rolls and i can walk stably without going over with every step on that foot it would be great same for being able to ease off some of the pain in my ankle due to the injury. I know there are risks but hopefully it will work out for the better. Anyone know what the percentage of success is with this type of ankle work? Is it really invasive on the ankle or what? How big a scar do you get? Just wondering about that as i was wondering how big it can be and how long it can take to recover? how long are you nwb? thanks

 
Old 12-20-2012, 09:24 PM   #8
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Hi Star, I've had numerous sprains, which caused ligaments/tendons to stretch, resulting in the unstable ankle. The ankle would "roll" constantly and about 8 years ago, I twisted my ankle, tearing the ligaments on the outside of the ankle. MRI showed the tears. Surgery to perform Brostrom repair was done and I had great results, no problems for several years. Then the ankle started becoming painful and a lot of swelling anytime I was on my feet, or walking. I had twisted my ankle several times during this period and had sprained again. II knew my ankle was totally loose, I could feel it, it looked as if my ankle was just hanging offthe bottom of my leg. Beginning of Oct, I was just walking and I felt a POP, followed by intense pain, I immediate swelling. Went to dr, had MRI, and that showed damaged tendons/ligaments. I had what felt like bones rubbing together when I walked. Boot was to see if those would heal, and my foot did feel better, as long as I wore the air cast. It basically held the ankle together.
Invasive? yes, I believe it's very invasive. I would encourage you to research ankle surgeries , these articles describe different surgeries, many articles have diagrams/pictures showing how surgery is done.
Scar from the surgery is pretty large. It has to be,,,,the dr has to open up the ankle in order to work in a relatively small space. Don't let that scare you. It does look pretty gruesome right now, but, with my first surgery, the incision looked bad
but healed so nicely that I could barely see the scar.
Recovery,,,,,I think full recovery will take a year. I'm not saying I'll be in treatment for a year, but for everything to settle down and completely heal, I believe a year is realistic.
NWB ,,,,,,during my pre op discussions with my dr, he anticipated that I'd be NWB at least 4 weeks, maybe more, , depending on how well I healed. Each dr has their own recovery protocol, and recovery depends on type of surgery.
I know the ankle will be very tight at first, but I'm looking forward to working thru PT to have a healthy, stable foot again.
Hope info helped you. Let us know if you have any other concerns. jeanne

 
Old 12-21-2012, 12:48 AM   #9
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Quote:
Originally Posted by Btrfli1 View Post
Hi Star, I've had numerous sprains, which caused ligaments/tendons to stretch, resulting in the unstable ankle. The ankle would "roll" constantly and about 8 years ago, I twisted my ankle, tearing the ligaments on the outside of the ankle. MRI showed the tears. Surgery to perform Brostrom repair was done and I had great results, no problems for several years. Then the ankle started becoming painful and a lot of swelling anytime I was on my feet, or walking. I had twisted my ankle several times during this period and had sprained again. II knew my ankle was totally loose, I could feel it, it looked as if my ankle was just hanging offthe bottom of my leg. Beginning of Oct, I was just walking and I felt a POP, followed by intense pain, I immediate swelling. Went to dr, had MRI, and that showed damaged tendons/ligaments. I had what felt like bones rubbing together when I walked. Boot was to see if those would heal, and my foot did feel better, as long as I wore the air cast. It basically held the ankle together.
Invasive? yes, I believe it's very invasive. I would encourage you to research ankle surgeries , these articles describe different surgeries, many articles have diagrams/pictures showing how surgery is done.
Scar from the surgery is pretty large. It has to be,,,,the dr has to open up the ankle in order to work in a relatively small space. Don't let that scare you. It does look pretty gruesome right now, but, with my first surgery, the incision looked bad
but healed so nicely that I could barely see the scar.
Recovery,,,,,I think full recovery will take a year. I'm not saying I'll be in treatment for a year, but for everything to settle down and completely heal, I believe a year is realistic.
NWB ,,,,,,during my pre op discussions with my dr, he anticipated that I'd be NWB at least 4 weeks, maybe more, , depending on how well I healed. Each dr has their own recovery protocol, and recovery depends on type of surgery.
I know the ankle will be very tight at first, but I'm looking forward to working thru PT to have a healthy, stable foot again.
Hope info helped you. Let us know if you have any other concerns. jeanne
Hey Jeanne, Thanks for the info now have my boot went to the physio today and bought it boy they aren't cheap but its worth just having if even if it seems it still rolls in the boot as it felt like it was making my leg go out due to my ankle instability still since it couldn't totally hold it up but oh well better than nothing and if i can kinda get out and do things again at least for now its better than nothing. My mum doesn't like the sound of it at all of surgery but then she doesn't like surgery and would avoid it at all costs where as i am of a mind if it could help its worth the risk! She also particularly doesn't like the stuff with the tendon possibly being taken from elsewhere in my body as she wonders how that body part would then function without that bit of the tendon there but to be honest i am 26 and my life is being ruined by my ankle and have been living for 3 years like this with the past 5 months the worst with multiple re injuries and the fact that its not healing at all which i felt it wasn't getting better as the same pains etc that were there always were not lessening at all makes me feel that its probably never going to get better without something being done. I have tried physio, osteopath who mainly works on clearing up clogging i have in my leg from my ankle so i guess that's important but yes and then there's also chiropractor, a guy who kinda helps out football teams that was putting ligaments etc back into place in my foot that kept coming out again, also a sports medicine doctor and a podiatrist when it first happened and i am sick of being stuck at home and not being able to get out and about unless my mum can give me lifts everywhere same for appointments can only be done when my mums around to drive me there! Am so sick of being cooped up and not able to live my life cause of it and i just loose it when all those things i have tried go wrong many times i have been questioning those people about pains i get cause of it and am in tears i am just over it all and want a normal life back where i can do things again i cant walk a single step without it rolling i get interrupted sleeping patterns depending on my ankle most nights when i go to bed i have to wait for some aches and pains to ease then i can sleep and i am just so over it all i just want to be better and be able to live my life and get out and enjoy it am sick of being cooped up at home oh well at least i know what is going on now sigh. Please excuse the rant just so tired of it all and it makes me so exhausted so i am to the stage where i feel it needs a more permanent solution than the physio etc could do it got to the stage where the physio just said go see an orthopedic doctor its to the stage i cant really help you anymore. i just want it better but yes thanks for your response its good to hear about your experiences it really is i am just to the point where i want a permanent solution and the physio and osteo etc could never give me that where i would totally have my life back.

What made you decide to have surgery in the first place? Hope all goes well with your recovery too thanks for all the help much appreciated guess now back to what i need to do here more work on my butt though lucky its for a course i am doing so have no excuse but to be on my butt and one final question how do you know if you are making the right decision about it all? As he said next appointment we will discuss your surgery and what we will do and to just try the boot first see if it stabilizes my ankle muscles at least which i don't think will happen as it rolls in the boot and then we will discuss surgery if it works then i don't have to come back and the surgery wont happen but i personally think it will need to happen as its never stabilized and doesn't feel like the boot is going to totally stop it from rolling either but yes how do you really know when you are making the right decision? when others might not like the decision you make cause they aren't for surgery? Just wondering thanks so much going to get back to my work now. Hope all is going well there for you

 
Old 12-21-2012, 01:02 AM   #10
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

oh and what is the success rate for something like this can i ask? Thanks

 
Old 12-21-2012, 07:31 AM   #11
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

sorry another question i just thought of how do the orthopedic surgeon decide if you need surgery or not? thanks

 
Old 12-21-2012, 07:46 AM   #12
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Star, please forgive me, but I am over 50 and my eyesight isn't what it could be. Could you use more periods when you post? It is hard to read sometimes and the punctuation helps me to grasp what you are saying.
Thanks,
Ginger

 
Old 12-21-2012, 08:04 AM   #13
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

sure can do
thanks for letting me know

Is there anything in particular you wanted me to explain ginger?

Just wanted to ask

Last edited by Star6; 12-21-2012 at 08:05 AM.

 
Old 12-21-2012, 08:05 AM   #14
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Star,
Decision to have surgery is a personal decision. My dr gave me his opinion, I did a lot of research, I discussed with my husband, and for me, the decision was based on my desire to have good quality of life. My ankle was bad enough that it was keeping me from doing simple things in my daily life. I couldn't be on that foot for any length of time without a lot of pain and swelling, sometimes to the point of tears. This had been going on for years and was getting worse and worse. I suggest you find out what dr recommends, do your research, and make the decision that you feel is right for you. This is your decision,,,,no one can make it for you. It is a rough surgery/recovery, but for me, it was the right decision and I felt it was the right time. Dr told me it was not going to be better without, and the risk of further injury, necessitating more invasive surgery, was not one I wanted to take.

 
Old 12-21-2012, 08:19 AM   #15
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Re: Answers for my Ankle Syndesmosis Injury! Yay! Possible ankle reconstruction?

Quote:
Originally Posted by Btrfli1 View Post
Star,
Decision to have surgery is a personal decision. My dr gave me his opinion, I did a lot of research, I discussed with my husband, and for me, the decision was based on my desire to have good quality of life. My ankle was bad enough that it was keeping me from doing simple things in my daily life. I couldn't be on that foot for any length of time without a lot of pain and swelling, sometimes to the point of tears. This had been going on for years and was getting worse and worse. I suggest you find out what dr recommends, do your research, and make the decision that you feel is right for you. This is your decision,,,,no one can make it for you. It is a rough surgery/recovery, but for me, it was the right decision and I felt it was the right time. Dr told me it was not going to be better without, and the risk of further injury, necessitating more invasive surgery, was not one I wanted to take.
Hmm can see your point and i know kinda how you feel about the quality of life and not being able to be on the foot often.

To be honest i dont have pain all the time but using it too much totally stirs it up! I have tried physio, osteopath, Chiropractor, sports medicine specialist, a guy that works with footballers, a podiatrist and have also tried using a tennis elbow strap which worked for a bit but no longer.

I have been told he highly doubts it will heal as according to my mri's from 4 months ago there was no signs of healing on them which means apparently that my body just decided it wasn't going to heal it anymore.

To be honest i feel out of places to turn and when i went to him and he told me all this stuff i hadn't been told and mentioned a bit about this ligament reconstruction with a tendon since the other fails more apparently and fixing the other things that needed to be fixed it was a huge relief to hear due to being at my wits end with my stupid ankle. And i have been feeling for awhile that my last option has come with the surgery i have tried everything else and i am tired of being bogged down and in pain etc.

Of course the Dr wont be explaining what he wants to do till i see him again on Feb 26th 2013 cause in the meantime he wants me to use a boot to at least build up muscle etc before he books me in for surgery.

Both me and my BF agree i need something more permanent done to allow me to live a better quality of life as i am sick of being stuck at home on my bum.

One thing i wonder though how do they decide who to offer surgery too or not? when do they decide it after looking at things or whilst looking? Just wondering as i was very surprised to be offered surgery to fix it up. And that it will probalary never heal.

He knew we had tried physio etc when he asked us questions but without touching my foot or anything and just looking at a ct scan he also picked up that i get pain in the back of my heel and a bit in my big toe. He also somehow knew i would be slightly numb on my bung foot or maybe that was just a test as he asked can you feel this as much whilst rubbing both feet! very surprised that my answer was no i cant. Thanks for your answers though they are helpful but i do feel if i am to ever get my life back i need to do this.

Guess i am just nervous about it all and what to do when the end of Feb next year comes around! So far though i am thinking i will take the surgery as the thought of continuing to live like this bums me out so much lol

Last edited by Star6; 12-21-2012 at 08:22 AM.

 
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