Midfoot and Hindfoot Fusion

What is a Fusion?

Fusion is permanently stiffening the bones of a joint together with plates, screws and/or staples. This procedure is also known as arthrodesis.

The aim of fusion is to improve pain and function by removing arthritis and joint instability. It is only recommended after a period of non-surgical treatment.

A simple way of thinking about fusion is "turning a painful and stiff joint into just a stiff joint".

Most fusions are done for arthritis. A few are done for severe joint instability when no other treatment works.

The surgical alternative to fusion is joint replacement (arthroplasty) but not all joints have this option. The hip and knee have excellent joint replacements so fusion of these is rarely performed. Ankle replacement is possible but uncommon (see Ankle Fusion and Replacement).

There are no midfoot or hindfoot joint replacements.

Midfoot fusion - 2nd TMT joint
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Midfoot fusion - 1st to 5th TMT joints
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Hindfoot fusion - subtalar joint
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Hindfoot fusion - "triple fusion"
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What Conditions do Midfoot and Hindfoot Fusion Help?

Midfoot and hindfoot fusion help people with:

Midfoot and Hindfoot Fusion Recovery

This surgical procedure involves fusing one or more of the midfoot and hindfoot joints. A common combination is called a hindfoot "triple fusion".

Note: big toe (IP and MTP) joint fusion does not require a boot or knee walker, just a post-op shoe for 6 to 8 weeks.

Surgery is done through one or several incisions. It can be a major surgical procedure and always takes time to heal.

Other surgical procedures maybe required at the same time:

calf lengthening or tendon transfer (see Flat Foot Reconstruction)
bone grafting.

Surgery:

requires a one or two night hospital stay
requires a general anaesthetic in most people
takes 60 to 90 minutes.

First 2 weeks:

bandage
"moon-boot" 24 hrs a day
crutches, frame or knee-walker
no weight-bearing
rest, elevation and ice (RICE)
careful ankle and toe movements
post-operative appointment.

Next 4 to 6 weeks:

"moon-boot" 24 hrs a day
crutches, frame or knee-walker
no weight-bearing
RICE as needed
careful ankle and toe movements
post-operative appointment and X-ray.

Next 6 weeks:

"moon-boot" to stand and walk
crutches, frame or knee-walker
increasing weight-bearing
careful ankle and toe movements
post-operative appointment and X-ray.

Next 9 months:

comfortable shoes
increasing activity
swelling control.

Benefits and risks:

90% of people are helped by surgery
complete pain-relief is rare
10% of people are not helped by surgery
1% of people are made worse by surgery.

Consequences and complications:

driving restrictions (2 to 4 months)
numbness around scars is common
swelling takes a year to settle
fusions do not heal in 5% of cases
metal implant removal is uncommon
see General Information about Surgery.

IMPORTANT

If you have any questions about your planned procedure, contact Dr Beamond before the day of surgery.

The information on this page is of a general nature and does not replace the informed consent process. Other consequences and risks specific (material) to the individual must be discussed prior to surgery.