Ankle fusion returns Officer to work and play

Donald Hunt (pictured right) is a patrol officer for the Lincoln Police Department, which means he has to be out there, among the people, keeping the peace. It’s rare, but he might even have to get into a scrape. And that’s tough to do when your right ankle hurts so much you start to wonder if you can take it anymore. The pain was so great, "There were times when I was ready to quit my job," Hunt says. Joshua Vest, DPM, is a podiatric surgeon at Capital Foot and Ankle Center who has advanced training in foot and ankle surgery. He knows there are certain words — like "fusion" — that might make people nervous. "When you say that word," he notes, "you can kind of see it in a patient’s eyes." Another scary word, when it comes to your foot and ankle area, might be "nail."

Living with pain
But could those words be worse than the pain the patient is already feeling? Dr. Vest performs an operation that contains both of those words: "hindfoot fusion nail." Because this procedure brought together Hunt and Dr. Vest, each wants to talk about how the other helped create this successful outcome. Hunt loves playing softball and all kinds of sports. He’s sprained his ankles countless times. But one sprain stands out: He turned for a ground ball, during a game 10 or 11 years ago, and it hurt so bad he had to be helped off the field. That had never happened. He kept thinking it would eventually get better, but it didn’t. He stood the pain for several years before he went to see a doctor, who told him he might need to have the right ankle fused someday. Well, even cops don’t like that word, and Hunt opted to have bone spurs taken out instead.

Photo: The Valor Hindfoot Fusion Nail system's hardware supports Donald Hunt's ankle.

Seeking options
"It hurt so bad afterward," he remembers. "In my case, it was not a good decision to have bone spurs removed." His pain just kept getting worse. "Every time I walked," he says, "it felt like I had a sprained ankle, for six and a half, seven years." It got so bad his right ankle started collapsing to the inside and kept getting closer and closer to the ground. Hunt could only grit his teeth and keep trying. Could he have chased down a bad guy? No way. Could he stand to live like this much longer? At last, he went to see Dr. Vest at Capital Foot and Ankle Center. Hunt remembers the physician saying, "I don’t know how you can even walk right now." "He had really severe ankle arthritis that was affecting his quality of life and his ability to do his job," says Dr. Vest. Thankfully, these days, there are options.

Dr. Vest often performs total ankle replacement surgeries for patients in such severe pain. But for someone as young — only 51 — and active — a weekend athlete and a cop — as Hunt, Dr. Vest recommended a treatment that’s new to Lincoln: the Wright Medical Valor Hindfoot Fusion Nail. The procedure holds up better to activity. And it’s simpler, less invasive and allows for a quicker comeback time. But there was that word, fusion. And the bad experience with taking out the bone spurs last time. What if it got worse? Hunt went up to the Mayo Clinic to tap their expertise. Physicians there agreed with Dr. Vest’s advice to fuse the ankle, so Hunt wondered whether traveling to Minnesota for pre- and post-operative visits, plus the surgery, could be avoided.

Returns to the scene
He went back to see Dr. Vest. He liked the doctor. He was positive, personable and told it straight. Dr. Vest liked him, too. "His was a very rewarding case," Dr. Vest says. "He’s a real salt of the earth guy." They did the procedure at Bryan. Dr. Vest fused Hunt’s right ankle, strengthening and stabilizing the whole thing with a titanium nail. Hunt says, "It was such a good decision. I’m so glad I did it — the difference is like night and day." Dr. Vest has since performed many surgeries using the new Valor nail technique, and all of the results have been good. He points out, "I think the key to having good outcomes is a combination of the right application of advances in technology and good communication between the patient and surgeon. A well-informed patient is important, and patients should do their homework on their options and their surgeon."

Photo: During a follow-up to Capital Foot and Ankle Center, Dr. Joshua Vest and Don Hunt discuss Hunt's progress after surgery.

Quick recovery
"In a little bit over five weeks, I was able to start putting pressure on it," Hunt says. "Dr. Vest said usually it’s six to eight weeks before a patient can do that. I think it’s because I was younger," Hunt explains. "I was in a boot, putting pressure on my right foot and walking and stuff. I used one of those little scooter things, that I kneeled on to get around, for almost a month and a half. Those are great inventions." He worked the service desk for a while at the Lincoln Police Department and started back on the street in a little more than three months. That’s quicker than most patients would, Dr. Vest cautions. It usually takes longer. "I have yet to have to chase anybody down," Hunt says. "But I’ve gotten into some physical altercations with people. The ankle didn’t bother me." Another bonus: He was able to get onto the softball field for the season’s last couple of weeks. Hunt can tell that his ankle’s fused. He might have a slight change in his gait, and he doesn’t move like a professional athlete. But he can run. Before, he worried that the slightest misstep could put him down for the count. And now he runs. "I’d never thought it’d be as good as it is," Hunt says. "Living six or seven years with so much pain, I thought if I could just reduce it in half, I’d be happy. Now, most of the time, 100 percent of the pain’s gone." One of the things patients worry about most with fusion is gait and loss of motion. Luckily for Hunt, Dr. Vest and the other specialists at Capital Foot and Ankle Center can address those post-surgical changes. Dr. Vest says, "Ankle arthritis used to be a debilitating diagnosis, but with the options we have now, it doesn’t have to be." Watch out, would-be bad guys: Officer Hunt is fit for the chase.