Ankle arthrodesis (fusion): Trans-fibular approach
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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 non-union.
Late onset subtalar and midfoot arthritis is likely as a radiographic phenomenon, though 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 with appropriate joint surface preparation 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:Mr Mark Herron, FRCS.
Institution: The Wellington Hospital, London, UK.