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Ankle Fusion

 Poster: A snowHead
Poster: A snowHead
Just back from hospital appointment with my consultant and am now awaiting a date for surgery to fuse my right ankle joint. Is skiing now a distant dream? Or does anyone know if you can still ski with a fused joint?

How do you even get your boots on? Puzzled HELP!!!!!!
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Obviously A snowHead isn't a real person
bev bish, hubby played squash with a guy who had both ankles fused, and still skied (he's well in his 70's now). . He walked rather oddly, it may have been the effects of the op, but the rumour was that he had asked the surgeon to fuse his ankle in a skiing position. He couldn't ski anything bumpy or steep because of his inability to flex the ankle joints.
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bev bish, Sad I don't know the answer, but is that your only option? My bro-in-law was knocked off his motor-bike some years ago and his ankle was smashed in the accident. Although fusion was strongly advised, he declined to have it fused, as he's quite active and sporty, and he got through the initial rehab with a lot of acupuncture. He's not even needed that lately and, so far as I know, he doesn't get much pain.
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Hells Bells, I walk rather oddly already - usually on the way back from the bar!! Pedantica, I too have a smashed ankle joint as a result of a motor bike accident, but that was 35 years ago and now have very severe problems with pain and swelling. Currently skiing on about 2,000 mg of ibruprofen a day with the aid of a ski mojo.
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bev bish, maybe you could have a word with CEM? He may have experience of fitting boots for someone with a fused ankle.
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bev bish, Sad Sad Sad
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Hells Bells, Chris has also just suggested that, it's a shame I did not know about this yesterday as he was at the NEC Ski Show.
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bev bish, My first suggestion is as Hells Bells, says... Talk to CEM. It may be that with some adjustments you'll be able get your boots on.
If you can't then skiing is still possible. I taught a guy with a fused ankle to ski as a "three tracker" A three tracker uses one leg/one ski and two outriggers. Outriggers are similar to a forearm crutch with a small ski on the bottom to help it slide over the snow. The idea of three tracking is to use the one leg/ski as normal, the outriggers are there to help with balance.
The guy with the fused ankle decided that three tracking was the answer because a). it was difficult to get a ski boot on and b). he had muscle wastage in that leg.
Skiing is not a distant dream... but you will probably need some adjustments.
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bev bish, We've done plenty, and no problems as yet, often plenty of work to do, depends on the extent of the problem and ROM left, a ski boot is often the best thing for them.
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SMALLZOOKEEPER, What sort of adaptation do you do then, and, far more importantly can they still ski with the fused joint?
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bev bish, I had a word with CEM about this problem in relation to one of my patients - and as SMALLZOOKEEPER has said, the short answer to "Is skiing now a distant dream?" is "No." Very Happy Very Happy Very Happy
All the best with the surgery and rehab.
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And love to help out and answer questions and of course, read each other's snow reports.
Thanks everyone for the sympathy and encoragement. Bev is being very positive and just wants to get into hospital and get the process started. She has done amazingly well to get this far, and by rights there is no way she should be walking never mind skiing and horse-riding (which is even more important to her than skiing.) Very few people are aware of the true state of her right leg, especially if they have skied with her. We really are at a very early stage of getting our heads round this, so all advice and experiences will be much appreciated.

snowHead
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I'm 20 and similarly riding and skiing are both rather important to me. I've been non weight bearing on one of my feet for 8 months having a congenital deformity corrected with a frame and one of the outcomes is that my ankle is practically fused now. I didn't have a great deal of movement in my ankle previously and could ski anything and everything, but with reasonably straight legs and adapted boots that were set more upright than your average pair. Now my ankle has very, very little movement and can just about get to 90 degrees with weight on it but I rode for the first time the other day and I fully intend on skiing for a good 40 more years! I always say that I'm better off in ski boots- much less likely to damage my ankle or foot! It's quite difficult getting in to boots because my toes are set too, but with normal toes that shouldn't be such a problem. Riding boot wise I need to wear very heavy duty boots with lots of ankle support and a rigid sole. How are you having it done?
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ckc157, Welcome to snowHeads!! Pity that your first post was on a possibly depressing topic (or a challenging one) if I am in an optimistic mood. wink I had my ankle, lower leg and knee smashed when I was only 18 and always knew that further nasty problems would develop now that I'm "old".......
I like your conviction that you will still be skiing in 40 years time - and I'm sure that you probably will be Very Happy . 35 years down the line after the injury I am still skiing, riding (with one stirrup at the moment), cycling, swimming etc, etc, but the pain is becoming a real issue, and like you, I have only very limited movement in the ankle joint left.
I'm getting very good at standing on one leg though!! Laughing

In answer to your last question athroscopically, (if that is how you spell it) and in January or earlier if I can pick up a cancellation. I am also attempting to train my little mare to harness just in case the riding gets too painful so that I can drive as well as ride, although attempting to long rein her on one leg is proving to be interesting to put it mildly......... Laughing Laughing Laughing


Last edited by You know it makes sense. on Tue 1-11-11 20:44; edited 1 time in total
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bev bish, I can talk to you via PM about the process. Puzzled
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 Poster: A snowHead
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SMALLZOOKEEPER, Of course - PM away! Grateful for any advice or information. Madeye-Smiley
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Latest news on this is that Bev's GP responded to the idea with a blunt, "You don't go from Ibuprofen to fusion." She has started Bev on a blend of Diclofenac and paracetamol which seems to be working well. She also has codeine as a back-up. She has managed a couple of rides this week as well as a couple of hours' walking. She also had a driving lesson. (No petrol involved.) Moving much better and even showing interest in a possible ski-date in December. We would still value any further advice. Thanks.

snowHead
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Well, the person's real but it's just a made up name, see?
Chris Bish, that sounds like good news. So glad.
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bev bish, Chris Bish, Much better news, I hope it continues that way.
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Chris Bish, sounds sensible . Good news.
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Probably a bit late in this thread but we do have some appraoches to fused ankles in the Adaptive Skiing world. Typically an ankle is fused at 90 degrees or close to it. The problem then in skiing is getting to a balanced "skiing stance" - ie the concept of a flexed ankle to stack your centre of mass dynamically over your feet. To achieve this we will normally look at putting heel lifts in the ski boot. This should be done with care and also be done by a specialist. If you put lifts in one boot ideally you shold do it in both so that you have the same leg length. Depending on your boot you might be able to get half and inch of lift.

One problem you will encounter with a fused ankle is simply getting a foot in a ski boot, the best type of boot for this is the old rear entry type. A boot with "walk mode" can help as it allows the boot leg to be more upright but it can still be very difficult.

Other options are to ski on one leg with hand held outriggers (we call this 3 tracking) but it is very tiring but another option is to ski sitting down. Monoskiing is a great blast and you can ski anywhere a standup skier can ski. Look up your local Adaptive Programme for more info - DSUK have instructors at all the indoor snow slopes.

Best of luck whatever you try.
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Tomichi, Thanks for this. My wife originated this thread when she was in a lot of pain and barely able to walk. Since then a new drug regime has helped her considerably. She has, as of last week, declined the operation and hopes to get another year or two out of her wrecked ankle. Your input is much appreciated.

snowHead
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I just posted about this. I ski with an ankle fusion but need more advice on boot and ski modifications. Ie, is there someone out there who specialises in this area?

Cheers
Eric
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Hi again

I'm revisiting this thread to ask for more info...

I've been skiing for years on a fused ankle - I have a pair of modded boots with an internal heel raise, custom orthotics etc. However, I still cannot attain a natural skiing stance. I'm in the back seat and need more lift under my heel to correct this.

Since I can not increase the internal heel raise, I would like to increase the heel height on the outside of the boot by around 2 cm. This would put me in an ideal ski stance.

Does somebody on the forum know where I can get this done?

Cheers
Eric
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ericbass, Apologies for not picking up your earlier response. Our boot guru is CEM. A pm to him will at least tell you if he can help. Otherwise he may be able to tell you who can.

snowHead
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bev bish, Last time I was out in the states I saw an older gentleman changing into his boots behind his car into this style of boot. He was a VietVet with some major lower leg injuries and he still skis with both ankles full of metal. I envied the way he slid into his boots.

http://fulltiltboots.com/


http://youtube.com/v/ov79dYsAMsY

No connection to the Co. Just thinking about them for my next pair of alpine gear.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
I broke an ankle quite badly playing footy and have had three operations on it which has resulted in it being more or less fused. I am not sure it affects my skiing ability because I am a fairly shite skier and started post operations. My posture is possibly affected but I wouldn't know. However, the mangled ankle is bigger than the other and swells significantly during the day which is a real pain.
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Hit eBay for some rear entry boots Very Happy
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 You know it makes sense.
You know it makes sense.
Tomichi wrote:
Probably a bit late in this thread but we do have some appraoches to fused ankles in the Adaptive Skiing world. Typically an ankle is fused at 90 degrees or close to it. The problem then in skiing is getting to a balanced "skiing stance" - ie the concept of a flexed ankle to stack your centre of mass dynamically over your feet. To achieve this we will normally look at putting heel lifts in the ski boot. This should be done with care and also be done by a specialist. If you put lifts in one boot ideally you shold do it in both so that you have the same leg length. Depending on your boot you might be able to get half and inch of lift.

One problem you will encounter with a fused ankle is simply getting a foot in a ski boot, the best type of boot for this is the old rear entry type. A boot with "walk mode" can help as it allows the boot leg to be more upright but it can still be very difficult.

Other options are to ski on one leg with hand held outriggers (we call this 3 tracking) but it is very tiring but another option is to ski sitting down. Monoskiing is a great blast and you can ski anywhere a standup skier can ski. Look up your local Adaptive Programme for more info - DSUK have instructors at all the indoor snow slopes.

Best of luck whatever you try.



I'm new to the forum. This person sounds like a professional and I'd like to learn more. Can I reach you?
Tim
tbatchelor@wpcap.com
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I thought ankle fusion was the reason why monoskis were invented?!?!
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 Poster: A snowHead
Poster: A snowHead
I have fitted boots to customers with club feet and fused ankles you can modify a full tilt boot as you do not have a problem getting your foot into the boot. You can also have a strolz boot made specifically where part of the shell is replaced with leather to enable easy entry.
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 Obviously A snowHead isn't a real person
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I have significant ankle arthritis and will be having my second surgery in two weeks. If that fails to provide relief I am looking at ankle fusion possibly later this year.

I do not feel that total ankle replacement is a wise choice in most if not all patients. Even though I am trained to perform it, I refuse to do it. (Ironically I am a podiatrist with a Ph.D. in biomedical engineering where my thesis was ankle stability).

I ski in Strolz boots (going on my third pair) and will either need to have it modified or get some different boots like Full Tilt. Not sure who or where to have these modified. I have some ideas but would like to have some specifics. If anyone has had experience with this, I would love your input.

Second I would love to ski with someone that has had their ankle fused especially anyone who is an expert skier. I would be willing to fly anywhere to ski with that person. I am considering giving up the sport since I prefer to ski bumps and the surgeons I have talked to about this as well as some data I can find suggest that will be difficult. Skiing groomers is not my gig albeit heli skiing may still be in play.
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@stephanlapointe@outlook.c, a friend had his ankles fused due to club feet.

He uses old rear entry boots but will ski pretty much anything. Pisted anyway.
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Is it just on one foot wouldnt it create a leg length discprepancy which could cause other problems later down the line? Best to get that fixed too.
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@Chris Bish,

I can see it was quite some time ago that you and Bev were talking about her ankle.
How are things now, as I know that kind of injury doesnt really improve with time.
I had a total ankle replacement 2 years ago now and still havent dared to try skiing on it.
My ankle is generally pain free but looks a funny shape now and has limited range of movement in certain directions
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Well, nearly nine years on and we are back where we started, more or less. Neither of us has skied for a year or two, as I managed to do an ACL in a moment of incompetence at La Plagne. I miss it more than she does. Bev has given up riding now, but still manages to get out with pony and trap. She got into a very bad way with pain so bad she could barely walk last summer. As a result, she has an appointment at Oswestry next Monday. Her GP has given her a nerve-blocking drug called Pre-gavelin (or something like that) which has helped a lot. She hopes to keep on going for at least another summer, but fears that she will be doing more damage the longer it goes on.

snowHead
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Best wishes to Bev. Whenever I thought my leg was in a bad way I'd always think of Bev
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@Chris Bish, my very best wishes too.
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@Chris Bish, well that's not such good news, you have my sincere condolences.
I know the pain story first hand, that's why I ended up with a new ankle joint, the daily pain was too much and the various painkillers weren't even taking the edge off, and it was suggested they were probably doing more harm than good e.g. ibuprofen.

The ankle replacement is definitely a double edged sword - daily life is much less painful, but my expectations of being able to leap back onto skis hasn't worked out quite as I had hoped. Perhaps I just need to take that leap of faith and start carefully, breaking it would be a total disaster, worst case requiring amputation of my foot!

best wishes to Bev, I hope it works out well for you both.
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Latest news is that Bev has had her fusion postponed for the trivial reason that she has a stress fracture of her lower leg. Needless to say, she has been carrying on as normal with cycling, horse-driving and walking. The consultant has dangled the possibility of replacement rather than fusion. It seems that the latest generation of plastic replacement joints are much improved, and he might be willing to give it a go. Either way, she has a six-month stay of execution, allowing her to take in a couple of cycling holidays we have planned. She has even wistfully suggested that if she does get a replacement, she may be able to ski again.

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