Ankle fusion, or ankle arthrodesis, is
surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
of the
ankle to
fuse
Fuse or FUSE may refer to:
Devices
* Fuse (electrical), a device used in electrical systems to protect against excessive current
** Fuse (automotive), a class of fuses for vehicles
* Fuse (hydraulic), a device used in hydraulic systems to protect ...
the
bone
A bone is a Stiffness, rigid Organ (biology), organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red blood cell, red and white blood cells, store minerals, provid ...
s to treat
arthritis
Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...
and for other purposes.
There are different types of ankle fusion surgery. The surgery involves the use of screws, plates, medical nails, and other hardware to achieve bone union.
Ankle fusion is considered to be the gold standard for treatment of end-stage ankle arthritis.
It trades joint mobility for relief from pain. Complications may include
infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
,
non-union
Nonunion is permanent failure of healing following a broken bone unless intervention (such as surgery) is performed. A fracture with nonunion generally forms a structural resemblance to a fibrous joint, and is therefore often called a "false jo ...
, and, rarely,
amputation
Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on indi ...
.
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Tibiotalocalcaneal arthrodesis
Tibiotalocalcaneal (TTC) arthrodesis is a special type of ankle fusion.
It is used in select situations, for instance as a salvage therapy in severe complicated cases or in other situations.
One major approach to TTC arthrodesis uses an intramedullary (IM) medical nail.
A 2011 systematic review reported the rate of bone union to be 87%, with a range of 74 to 93% in different studies.
The average time to union was 4.5 months.
Only 26% of cases of non-union required revision fusion, with the remaining cases being asymptomatic or not being severe enough to require revision.
It was concluded that the nail can oftentimes provide structural support and relief from pain even without union.
The complication rate was 56%, with hardware-related problems comprising a majority of complications.
The rate of reoperation was 22%, with screw removal done in 11.4%, nail removal done in 4.2%, revision fusion done in 3.4%, and amputation in 1.5%.
The review concluded that there is a good fusion rate with TTC arthrodesis using an IM nail but that the surgery has a high rate of complications.
On the other hand, a 2016 review concluded that there was a low rate of complications.
See also
*
Ankle replacement
References
{{Bone, cartilage, and joint procedures
Orthopedic surgical procedures