Open ankle fusion:(trans-fibula approach) surgical technique
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An open ankle fusion is a relatively straight-forward operation which in appropriate patients is transformatory (both in terms of pain reduction and function).
The “risk” associated is in practical terms “front loaded” and relates mainly to the risk of non-union
Late onset subtalar and midfoot arthritis is likely as a radiographic phenomenon but not likely to require later surgery.
There are a number of different techniques described to perform the operation. Which one is chosen is less relevant than ensuring a correct and functional alignment is achieved intra-operatively and that the compensatory joints (subtalar and midfoot) are free of significant arthritic change and asymptomatic.
A sound ankle fusion is entirely compatible with heavy manual work
Author: Mark Herron FRCS
Institution: The Wellington Hospital , London