Transfibular Ankle Fusion

Diagram-of-the-Bracket-or-Mortise-Structure-of-the-Ankle-JointAlso referred to using the term Ankle Arthrodesis, a foot and ankle surgeon performs an Ankle Fusion to treat severe arthritis within the ankle joint. The term fusion comes from the fact that the surgeon literally fuses or combines the ankle bones together to create one large piece. While surgeons typically perform ankle fusions due to the effects of arthritis, they may also perform an ankle fusion due to an injury or infection. Ankle fusions work to reduce or relieve pain due to reducing the amount of movement in the joint and clearing the joint of diseased tissue. Following a transfibular ankle fusion, the patient most likely cannot flex or extend the foot but they can still move the foot and ankle side to side.  

How do surgeons perform transfibular ankle fusions

To perform a transfibular ankle fusion, an anesthesiologist places the patient under general anesthesia. Under general anesthesia, the patient remains fully asleep for the entirety of the procedure. While asleep, the patient cannot feel anything.

The surgeon then starts the procedure. To start a transfibular ankle fusion, the surgeon creates an incision on the outside of the ankle, exposing the joint. The surgeon then removes a portion of the distal fibula. Next, the foot and ankle surgeon removes damaged bone and cartilage from the distal tibia and proximal talus. The surgeon then contours and properly reshapes the bones, realigning them to properly fit. During this step, the foot and ankle surgeon may need to use a bone graft depending on how much damaged bone they had to remove. This bone graft may come from cadaver tissue or come from the removed piece of fibula, calcaneus, or pelvis. Once the surgeon achieves proper alignment, the surgeon uses plates and/or screws to secure the new alignment. That completes the transfibular ankle fusion procedure.

Recovering from a transfibular ankle fusion

While the ankle heals, the patient must wear a cast to protect the healing joint. The patient must also use crutches while walking for 6-8 weeks following the procedure to ensure they do not place weight on the healing ankle. TalusFollowing a transfibular ankle fusion, the patient must participate in physical therapy to ensure proper healing of the tissues. The ankle should heal completely within 3-6 months.

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