Triple Arthrodesis

The foot is made up of 26 bones and 33 joints. Three joints at the back of the foot, namely, subtalar, talonavicular and calcaneocuboid joints allow the side to side movement of the foot. These three joints can become deformed from arthritis. Arthritis is inflammation caused due to the wearing off of the cushioning cartilage present on the joints. Arthritis causes pain, swelling, stiffness, and limited movement. A long-standing deformity such as flat foot can also cause severe pain.

Triple arthrodesis is a surgical procedure carried out to fuse these joints.

The procedure aims at correcting the deformity, restoring stability at the back of the foot, and relieving pain.

Indications

When conservative treatment measures such as NSAIDs (non-steroidal anti-inflammatory drugs), Physical Therapy, strapping, steroid injections and bracing are ineffective for the patient, then Triple arthrodesis surgery may be recommended. This surgery is indicated to relieve pain and correct deformities only when conservative treatment fails to provide relief.

Triple Arthrodesis surgery may also be indicated for

Foot deformities that cannot be adequately braced

Arthritis

Flat foot

Joint instability

Neuromuscular disorders

Surgical procedure

Triple arthrodesis is performed under local or general anesthesia and takes around 2 to 2.5 hours to complete. Your surgeon will make two incisions on the foot to gain access to the joints. The damaged arthritic cartilage is removed and the bones are re-aligned. Bone graft is filled into the joints to help the bones to fuse. Metal screws and staples are used to keep the bones in place while they heal. The tissue layers and the incisions are then sewed back and dressed.

Post-Operative Care

After the surgery, you may need to be in the hospital for 2 to 3 days. Your leg will be placed in a splint that reaches up to your knee and you may require crutches for walking. You will be prescribed pain medication to relieve post-operative pain. The foot will have to be kept raised to reduce swelling.

During your post-operative visit, your foot will be examined to check that the fusion is healing and to remove your stiches. You will be prescribed compression stockings and your foot will be placed in a walking boot. Post Op care usually involves a session of physical therapy for about 6 weeks. You will be able to get back to work within 12 to 14 weeks once the bones have healed.

Risks and complications

As is the case with any surgery, there are certain potential risks and complications involved in this procedure as well. Some of the risks include:

non-union wherein the fusion site fails to adequately unite together

infection

wound healing

nerve injury

The risks are increased in patients with diabetes as well as smokers.

Triple arthrodesis is a time-tested and effective procedure in the treatment of various foot deformities and malformations. The procedure can bring about pain relief, improved function, correction of deformity, and stabilization of the rear foot. The risks and complications can be minimized with effective planning, proper technical execution, and strict postoperative management.