I found a highly regarded specialist and paid for his opinion even though he i snot in my insurance network. I figured he would help me understand my situation (8 month “healed” pilon fracture) as well as it can be understood. The person I saw is Dr. Roger Mann and he said though the joint has lost its space due to cartilage degradation, there may be an opportunity to clean up some bony growth and get me some results.
If not, I am looking at an ankle fusion. He feels I am too young and active for an ankle replacement. Apparently the ankle replacements have a polyurethane bearing surface that will not last long enough for m and I’d ned future surgeries to maintain it. He also said a fusion is a good straightforward fix that will allow me to be pretty active.

I would be very thankful at this point to have a strong-yet-imobile joint instead of what I have now. (Tibia crashing into talus and 0 dorsiflexion.