Ankle Fusion

ExitCare ImageAnkle fusion surgery joins (fuses) ankle and leg bones together. The surgery uses devices such as screws, plates, rods, pins, and sometimes bone graft material. This is usually done to repair damage to the ankle due to arthritis, injury, or infection. It is also done to repair other ankle and foot conditions that cause pain.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

As with any surgery, complications may occur. However, they can usually be managed by your caregiver. General surgical complications may include:

  • Reaction to anesthesia.

  • Damage to surrounding nerves, tissues, or blood vessels.

  • Infection.

  • Bleeding.

  • Scarring.

  • Blood clot.

With appropriate treatment and rehabilitation, the following complications are very uncommon:

  • Failure to heal (nonunion).

  • Healing in a poor position (malunion).

  • Stiff ankle or loss of mobility.

BEFORE THE PROCEDURE

Follow your caregiver's instructions prior to your surgery to avoid complications. A physical exam and X-rays may be performed as well. You may be asked to:

  • Stop taking certain medicines for several days prior to your surgery, such as blood thinners (anticoagulants).

  • Avoid eating and drinking for at least 8 hours before the surgery. This will help you avoid complications from anesthesia.

  • Quit smoking, if this applies. Smoking increases the chances of a healing problem after your surgery. If you are thinking about quitting, ask your surgeon how long before the surgery you should stop smoking. Ask your primary caregiver about approaches to help you stop. This can include medicines.

  • Arrange for a ride home after your surgery. Arrange for someone to help you with activities during recovery.

PROCEDURE

The surgery is done after you are given medicine that makes you sleep (general anesthetic) or medicine that makes you numb from the waist down (spinal anesthetic). You will be asleep and will not feel any pain. The surgery can be performed with open surgery or minimally invasive surgery using a thin, lighted tube inserted through a small cut (arthroscopy). There are several variations of ankle fusion, but the basic surgery involves the following:

Open Surgery

Cuts (incisions) are made on each side of the ankle to allow the surgeon to access the joint. Once the joint is opened, cartilage and bone surfaces may be removed and reshaped if needed. The joint is repositioned in the proper place and joined together with a device, such as screws or plates. The body's natural healing process will help fuse together newly formed surfaces within the ankle. Though less common, sometimes pins within the ankle joint are attached to outside rods (external fixator) to aid in the healing process.

Arthroscopic Surgery

Small keyhole incisions are made on either side of the ankle. The surgeon will insert small instruments into the ankle joint. A tiny camera allows the surgeon to view inside the ankle. Small tools are used to resurface the cartilage area and bones of the ankle. Screws are placed through the skin and ankle to help it stay in position while it heals.

AFTER THE PROCEDURE

  • You will likely be in the hospital for 1 to 2 days following surgery.

  • Caregivers will help you to manage pain and swelling with medicines, ice, and raising (elevation) of the ankle.

  • Full recovery will take several months, but you may be able to walk gently in about 12 weeks. Crutches will help you move around when you first return home.

  • A cast or splint will be applied to the lower leg. You will learn how to walk with crutches.

  • Follow your caregiver's instructions for home care after surgery.

FOR MORE INFORMATION

American Academy of Orthopaedic Surgeons: www.aaos.org