Physiotherapy in North America for Ankle
Q: Years ago, I broke and dislocated my right ankle. Everything healed nicely at the time. But, now the pain from arthritis has really gotten to me. The surgeon recommends fusion of the two main joints. I forgot to ask if I'll need a brace or anything like that.
A: The type of fusion you are describing is called a tibiotalocalcaneal arthrodesis. Tibio-talo-calcaneal refers to the three bones that will be fused together. Essentially, your ankle and subtalar joint will be fused. Arthrodesis is the medical term for fusion.
There are various ways to surgically fuse these joints together. Screws, nails, and plates are possible options. These devices are used to hold the joint in place until the bone graft fills in and forms a solid fusion.
There will be a loss of ankle motion but bracing isn't usually needed. The fusion provides the stability you need. But without movement at the ankle, you may need a good, supportive shoe. Shoe modifications can be made to accommodate any residual deformity that might be present.
Some patients require a high orthopedic shoe. Others may only need a heel raise or modification to the sole. Most (90 per cent or more) patients who have this type of fusion need some kind of shoe modification at least.
Reference: Ronald Boer, MRCSEd, et al. Tibiotalocalcaneal Arthrodesis Using a Reamed Retrograde Locking Nail. In Clinical Orthopaedics and Related Research. October 2007. No. 463. Pp.