Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Arthrodesis of Foot and Ankle—Open Surgery

Pronounced: AR-throw-DEE-sis of foot and an-kuhl
by Ricker Polsdorfer, MD
Definition

Arthrodesis fuses (welds) together the two bones that form a joint. There is no longer movement in the joint after the procedure. One or more related joints may be done at the same time.

Reasons for Procedure

Ankle arthrodesis is used to relieve disabling ankle pain or deformity caused by poorly healed fractures, arthritis , infections, or developmental defects.

Satisfactory results, including good pain relief, are achieved in most patients. Most can wear ordinary shoes. Some will benefit from specially fitted footwear.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have an arthrodesis, your doctor will review a list of possible complications, which may include:

  • Bleeding
  • Failure of the joint to fuse
  • Infection
  • Need for repeat surgery
  • Nerve damage
  • Poor alignment of the joint, causing pain and/or an altered gait

Factors that may increase the risk of complications include:

  • Infection
  • Smoking
  • Some chronic diseases
  • Steroid medicines
What to Expect
Prior to Procedure

Several nonsurgical treatments will be tried to correct the problem before choosing surgery. These may include medicines, injections, special shoes, or types of physical therapy. You will have a thorough evaluation to determine your overall health and any risk factors.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

  • Blood thinners, such as warfarin (Coumadin)
  • Aspirin or other anti-inflammatory drugs
  • Clopidogrel (Plavix)

Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.

Arrange for help at home after returning from the hospital.

Anesthesia

Your doctor may choose:

Description of the Procedure

The doctor will make a long incision so that he can see the joint. He will then secure the joint. There are many ways to secure the two bones together so that they no longer move in relation to one another. Long screws, screws and steel plates, long steel rods, and bone grafts have all been used.

You will have a tourniquet strapped around your thigh to shut off circulation so that the surgery can be performed in a bloodless field. Your leg will not suffer ill effects from the tourniquet.

Immediately After Procedure

Your lower leg will be in a rigid cast and be elevated after surgery. You will be offered pain medicine.

How Long Will It Take?

About 2-3 hours

How Much Will It Hurt?

There will be no pain during the procedure. Afterwards, there will be some discomfort. Talk to your doctor about medicine to help manage discomfort.

Average Hospital Stay

Barring complications, you may be able to go home in 2-4 days.

Postoperative Care

It will take up to four months to heal and solidly fuse the joint(s). During that time, you will be in a cast. After the procedure, be sure to follow your doctor's instructions . Ask your doctor about when it is safe to shower, bathe, or soak in water.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs: In case of an emergency, call for medical help right away.

  • Bleeding or discharge from your incision(s). This may show up as staining of your cast.
  • Cough, shortness of breath, chest pain, or severe nausea and vomiting
  • Increasing or severe pain that is not relieved by your pain medicine
  • Numbness, tingling, or discoloration in the foot
  • Signs of infection, including fever and chills

Last reviewed: December 2011 by John C. Keel, MD.

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