Hindfoot fusion surgery

(subtalar/triple joints)

The joints below and in front of the ankle joints (the triple complex) can become worn out (arthritis) or have large deformity. These three joints can be affected in isolation or in combination. Correction of the arthritic problem or large deformities can be completed by fusing these joints to make them stiff, relieve pain and hold an improved position.

This procedure is typically done via incisions on the inside and outside parts of the foot below the ankle. The joint surfaces are prepared back to bleeding bone and all cartilage is removed. The deformities are corrected and screws, staples and/or plates are used to hold the position and compress the joints. Bone graft is often added as an adjunct to assist with healing.

The goal is to turn already stiff, painful joints into stiff, painless joints

Figure 1: subtalar fusion surgery

Figure 2: triple fusion procedure

Success rates: more than 80-85% of patients are satisfied with the fusion procedure.

 

Post-operative plan:

  • Surgery is typically a 1-2 night hospital stay

  • a nerve block is administered to help with pain

  • 0-2 weeks: elevation at home, non weight bearing

  • 2-6 weeks: non weight bearing, change to CAMboot in most casts. From four weeks patients can typically start weight bearing in the boot.

  • 6-10 weeks onwards: weaning out of boot and progressing to strengthening

  • 10 weeks onwards: wean out of CAMboot fully and progress to walking in normal shoes. Ongoing recovery up to 1 year after surgery

Download post-operative care guide

 

Risks of surgery

  • Swelling, stiffness

  • Infection and wound breakdown

  • Wound healing problems

  • Blood clots

  • Scar sensitivity

  • Non union (fusion not taking) – this risk is approximately 5-8% in a simple case, complex cases can have higher non union rates.