Triple fusion

What is triple fusion?

There are three joints at the back of the foot below the ankle called the subtalar, talo-navicular and calcaneo-cuboid joints. Arthritis in these joints can cause pain and deformity. A triple fusion is a fusion of these three joints to reduce pain and correct any deformity if present.

What does this involve?

The procedure is usually performed under general anaesthetic and you will require an overnight stay in hospital. An incision is made on both the inside and the outside of your foot. The surfaces are then removed from the three joints and any reshaping necessary is carried out. The joints are then placed into their correct positions and each joint is held together with screws and/or staples.

When will I recover?

For the first few weeks following surgery you will need to elevate your foot as much as possible to reduce swelling. This will both make the foot more comfortable and help the wounds to heal.

After the operation, you will not be able to put weight through your foot for two weeks. At two weeks, you will have your stitches removed and you will be placed in a light-weight cast. Using crutches, for six weeks you can place about half your weight through this cast when walking. At eight weeks after surgery, you will be placed in a removable boot to walk in for four more weeks and will be able to put all your weight through this boot. At three months following surgery, you will be able to return to normal shoe wear. The swelling can take from six months to a year to completely resolve.

 

What risks should I know about?

A triple fusion of the rearfoot is a commonly performed and generally safe procedure but there are some potential complications you should be aware of.  These affect a very small percentage of patients.

  • Infection can occur although our theatres have ultra-clean air operating conditions keeping infection rates to the minimum.
  • Blood clots are possible after any operation and are more common in patients with some pre-existing medical conditions. However, again they affect a very small percentage of patients and have well established treatments including aspirin.
  • Very rarely, damage to the nerves around the ankle and foot leading to numbness, pain and in some cases weakness in the foot - this usually settles on its own. 
  • The foot fusion may fail/ not give rise to the intended benefits of reduced pain in the rearfoot

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