Wednesday, April 27, 2005

Triple Arthrodesis

Triple Arthrodesis
Originally uploaded by terpkristin.
Finally I was able to get a picture of my xray up on the web. This is my ankle after my surgery on 25 June 2004, where Dr. Mark Myerson performed a triple arthrodesis (complete fusion), sural neurectomy (removal of a portion of the sural nerve), and Chrisman-Snook lateral ligament reconstruction (well, to be honest, a re-re-reconstruction). What can I say, I was a mess. If you click on the picture, it should take you to its flickr page where you can roll your mouse over a few of the notes I added.

For those who don't remember or don't know, the fusion was not the first surgery I had on my ankle and in fact was only performed because I had three prior failed surgeries. My injury progression was:
3 July 2001: Initial injury (acute ankle sprain), which happened when I went up for a head ball while playing soccer and came down on the outside of my ankle/foot intead. OUCH. It turned out that the 3 main ligaments on the outside of my ankle had completely snapped--not just torn or stretched, but snapped right apart.
27 July 2001 & 20 December 2001: Shoulder surgeries. Not related to the ankle at all, but because of these surgeries, I didn't worry too much about my ankle until I was ready to try to play soccer again and couldn't.
mid-March 2002: Realized I could barely walk without rolling my ankle so saw my orthopaedic surgeon. He advised physical therapy to strengthen the muscles that support the ankle.
mid-June 2002: PT's laughed at me because my ankle was so bad that we couldn't even keep it from rolling DURING rehab. They sent me back to my surgeon.
15 August 2002: Ankle surgery #1. Watson-Jones procedure to repair the ankle ligaments by using a graft from the peroneus brevis tendon.
First half of 2003: Still in pain following ankle surgery #1, I continue to do rehab. Finally I get referred to a different surgeon, Dr. Paul Cooper at Georgetown University Hospital.
6 August 2003: Dr. Cooper performs ankle surgery #2, an arthroscopic debriedment of my ankle and an open reconstruction of the peroneal tendons (brevis and longus) and re-reconstruction of the lateral ligaments.
24 December 2003: Dr. Cooper performs ankle surgery #3, where he intended to use a cadeaver tendon to re-reconstruct my peroneal tendons (see above). When he got in there, though, he discovered that the muscle in my calf/foot was atrophied to an extent that he couldn't attach the tendon anywhere (this is what happens when you can't exercise for over a year due to pain). Instead, he ended up detaching a tendon from the bottom of my foot and re-routing it behind my tib/fib and used it to "recreate" my peroneus brevis and longus.
25 June 2004: All other surgeries had failed and my gait was severely affected, I finally saw Dr. Mark Myerson who recommended the triple arthrodesis and other procedures. While I can't say that I'm yet 100% pain-free, my gait is mostly normal again and though I'll never run or really jump again, I'm slowly returning to an active life (mostly biking, and I'd be more active if I had a job so I could have insurance so I could get back into physical therapy).

1 comment:


Quick History: Fell 3 yrs ago this comming Oct. 16, broke both Calcaneous(s), Achiles tear on my left ankle, as well as some fractured bones internal to the actual joint, again both ankles.
Psuedo Trauma repair @ GW in D.C., performed by Labropolous. "Lots of metal"
Lt ankle failed to repair, 2nd surgery, Trip. Arthro., Performed 1yr. later by Derner in Lake Ridge VA.
5 weeks later involved in 5 car accident "middle car", destroyed Trip., as well as re-injuring Rt ankle, and both Knees. Never made it Phy. therapy. Walk'd w/ cane for almost 3 yrs.. "Very painful".

?? I am scheduled for a rebuild to the Lt ankle on the 26th of Aug, 05, I am trying to educate myself w/ respect to alternatives...
Implant??, Joint replacement??

Any ideas...