Subtalar Fusion

SUBTALAR FUSION

The subtalar joint is located just below the ankle joint between the talus bone and the calcaneus (heel) bone. The main job of the subtalar joint is to allow for side-to-side movement of the foot and ankle. This movement aids in walking, especially on uneven surfaces.

A fusion surgery locks bones together and is appropriate for diseased joints that can’t be replaced. Once a fusion heals together, it acts as one unit and can restore function and provide significant pain relief. Generally speaking, fusion also is very durable.

Subtalar fusion is performed to either correct rigid, painful deformities or instability of the subtalar joint, or to remove painful arthritis of this joint. During surgery, this joint between the talus bone above and calcaneus bone below is removed as the joint surfaces are fixed together. The goals of subtalar fusion are to decrease symptoms and allow improved function with less pain.

Subtalar fusion generally is performed for three reasons: to correct deformity, correct instability, or treat painful arthritis. Causes of arthritis include trauma, degeneration, rheumatologic conditions, and infections.

SURGERY
Patients are positioned on their back or side to allow exposure of the operative leg. Subtalar fusion is most often performed through an incision on the outer side of the foot. The joint surfaces are prepared by removing all cartilage and correcting all deformity. The bone surfaces are roughened to stimulate bleeding. This bleeding allows the two bones to heal together after the joint is fixed with hardware (screws). X-rays will be used during the surgery to ensure proper alignment and hardware position. Sometimes bone graft is added to help the healing. Once surgery is finished, the foot and ankle are placed in a well-padded splint.

COMPLICATIONS
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.

A potential complication of any fusion procedure is a failure of the fusion to heal, which is called a nonunion. Healing in a bad position also can occur, but this is rare. Following your surgeon's instructions is very important to avoid complications.

FREQUENTLY ASKED QUESTIONS
  • How will subtalar fusion affect my walking?

    Although this surgery stiffens the hindfoot (back of the foot), what patients lose in motion they typically make up for in stability and pain relief. Most people tend to walk better after the surgery. There may be some getting used to walking on uneven surfaces and getting used to their "new foot," but most patients have such improved function they would do the procedure over again.

  • When will I be able to walk?

    This depends on many factors. Clinical and X-ray evidence of healing are required to determine an appropriate time to start walking. Although partial weightbearing often is allowed within a few weeks after surgery, full weightbearing in shoes usually takes at least 8-12 weeks.

  • What will I use to get around after surgery?

    Some form of walking aid will be required. Most patients get around with crutches, a walker, or a rolling knee walker/scooter after surgery. A cane is not acceptable, as no weight is allowed on your surgical foot until you discuss it with your surgeon.

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Information provided by American Orthopedic Foot and Ankle Society (AOFAS) via FootCareMD.com
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