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.


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