My ankle was in 27 pieces in 1992..
My lower leg bones were both broken. Lots of hardware and scarring. My doctor at the time knew riding was important. I returned to have the cast replaced every two weeks, each time, he'd pull the toe on that foot up a bit more to stretch that tendon out so it wouldn't lose that mobility.
Can I point my toe like a ballerina now? Nope, but my heel goes down. A lot.
Does a sports medicine boot type brace help? a little with stability, not at all with pain.
A fact of my life is that since late December 1992, my right ankle has been very painful, every step, every hour, every day. When it gets too bad, I rest it. It hurts if I'm in two point a lot during a ride or jumping, or on a long ride, it hurts a lot. Driving makes me limp visibly.
Sometimes, bute is my friend, sometimes, dmso and cortisone is my friend. Sometimes, I get a prednisone dose pack for something else and have a couple of days of relief.
I wouldn't fuse mine until they could assure me that I would be pain free or until it absolutely refused to support me.
There are some things on your body that after a while, are just going to hurt until you draw your last breath. No one who is seriously involved in horses is pain free.
If you've ever taken steroids for anything, it's pretty easy to figure out why pro athletes abuse them. If they were legal and didn't have any nasty little side effects, I'd be all over it.