What's in an ankle?

Technology is amazing stuff, and I'm a bit of an idiot.

Last November I "sprained" my ankle in crown tourney but was enjoying the fighting enough that I kept fighting ...and again the next day. Did I mention I walked half a km home at 4am?

Ankle's sprain right? Bit's tear slightly or inflame and get over it, no problem. Sure, except when you half break it. In hindsight, with the effect it's had on my life I wish I'd broken it properly and gone through a known and obvious healing program. As it is, after 6mths of physio with the last three not fighting and limited dog walking, it didn't look like it was going to take care of itself so I got an MRI and then went to a specialist.

On 5th Sept I went in for keyhole surgery with the view that a reasonably definite heal time is better than an uncertain one. After seeing the arthroscope pics from inside my ankle I'm glad I did as I don't think it would have healed properly otherwise.

I have to say I was disappointed with the anaesthetic experience. One minute I'm bored while waiting in the pre-op room, next the nurse is telling me I have to go to the toilet and do I want tea or coffee (and is your lift here yet so we can go home). No fading out while counting backwards, no pink elephants, just blackout and then feeling like a record player that's still switched on sounds as the power comes back on sporadically.

Anyway, overall it was apparently successful. There is still a certain amount of finger crossing though as the doctor also found I'd damaged the ligaments joining my tibia and fibula, which, if they give me trouble once the other one is settled, means going back in for a pin. Downside of that is 6wks on crutches and 6mths of taking it easy rather than the current 10 days and 6wks.

And here's the pics:

First the side view MRI, red circled bit is the area of damage. Light grey bit on lower bone is bone bruising (ie: crushed), the wiggly thin black bit above that is the cartilage and should be a smooth curve, the bright white bits are fluid which shouldn't be there.


















This is the front view through the middle of my ankle (cool huh?). The bit in the blue circle is the same as the one above, with the smashed cartilage and the bit in the blue box is where the ligament damage is. This pic really shows something I never knew about ankles, they're a square peg in a square hole. Hence why rotating sideways is bad news!




(Warning: Pics of bone etc inside my ankle following, if you are squeamish ... this is a good chance to desensitise.)





















Now this is inside my ankle during surgery. The first pic is what good cartilage looks like and on the right is what missing and flaky bits of cartilage looks like. (The silver thing on the left is one of the surgical instruments.)

First they clear away the loose cartilage (pic1) and then roughen up the bone surface to promote a scab to form which will apparently heal like a fibrous form of cartilage just not as good. And I'm guessing I'll really be paying for it in 20~30yrs time.
And this is the gap between tib and fib where ligaments should be tenaciously doing their job of stopping the square hole getting bigger.

All up it's kinda cool and gives me hope of the end being in sight. Although it' going slow at the moment and I'm having doubts about my ability to be off the crutches this weekend and am really quite dubious about being able to fight by November. The doctor said that I could expect to be "good on level ground by 6wks with some issues on uneven ground".