Q: Years ago, I broke and dislocated my right ankle. It healed well at the time, but now arthritis has caused significant pain. My surgeon recommends fusing the two main joints. I forgot to ask if I’ll need a brace or anything similar.
A: The procedure you’re referring to is known as a tibiotalocalcaneal arthrodesis. This term describes the fusion of three bones: the tibia, talus, and calcaneus. Essentially, both your ankle and subtalar joint will be fused together. Arthrodesis is the medical term for this type of fusion.
There are several surgical methods to achieve this fusion, including the use of screws, nails, or plates. These devices help hold the joint in position until the bone graft integrates and forms a solid fusion.
Although you will experience a loss of ankle motion, bracing is generally not necessary. The fusion itself provides the stability required. However, without ankle movement, you may need to wear a supportive shoe. Adjustments can be made to the shoe to accommodate any residual deformities that may remain.
Some patients may need a high-top orthopedic shoe, while others might only require a heel lift or a modification to the shoe’s sole. Most patients (over 90%) who undergo this type of fusion will need some form of shoe modification.
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.