Ankle Fusion Surgery

What is ankle fusion surgery?

A bunion or hallux valgus is a bony lump that appears at the bottom of the big toe, causing the toe to bend inwards. This lump is created by the effect of the metatarsal bone, the protruding bone, rubbing against the shoe. Its Latin name, hallux valgus, derives from ‘hallux’ for ‘big toe’ and ‘valgus’ which translates as ‘pointing outwards’. Another variant, affecting the small toe, is known as the Tailor’s bunion.

The objective of ankle fusion surgery is the permanent fusion of the bones to stiffen them and stop them from damaging each other.

What does ankle fusion surgery involve?

The patient will be put under a general anaesthetic, together with another injection to numb the area at the site of the operation to numb and minimise pain.

Your consultant will first take away any damaged cartilage before fusing the tibia and talus, the two main bones of your ankle. Should additional bone be required, this can be provided from your hip bone or by using donor bone.

Attending a pre-assessment screening is good way of maximising the benefits of your surgery. At your screening, you’ll have your blood tested to assess your Vitamin D levels; swabs will be taken to check for infection or other issues; you’ll be weighed and have a chance to talk through your medical history, to highlight any potential anaesthetics issues.

It is highly recommended that you stop smoking at least eight weeks before surgery because smoking affects your ability to heal and leads to health issues, such as greater risk of pulmonary embolism (blood clots forming in the lungs), deep vein thrombosis (blood clots in the calf) and infection in particular.

Why might I need ankle fusion surgery?

If you have damaged cartilage in your ankle, caused by ankle arthritis/osteoarthritis or have an ankle fracture, you may be a suitable candidate for ankle fusion surgery.

How long does it take to recover?

You will usually stay in hospital for 2 days following the operation. A physiotherapist will assist you out of bed and show you how to use suitable walking aids as you will not be able to put any weight through your operated foot for at least 6 weeks and you’ll have a plaster cast as high as your knee.

You should anticipate at least a 12-week period of convalescence at home before you are able to resume your normal activities. You will need to use crutches when walking or climbing stairs as you will not be able to bear weight through the ankle.

Most people prefer not to drive until the plaster cast is off, they can wear a shoe and are able to fully weight bear. If only your left foot is operated on and you have an automatic car, you can drive within a few weeks of the operation, when your foot is comfortable enough and you can bear weight through it.

How soon you are able to return to work will depend on the type of job you do. It will be at least 6 weeks before you can return, longer if you have a manual job or need to stand for long periods.

What is the long-term impact of ankle fusion surgery?

Patients will progress and recover from their surgery at different rates. It can take up to a year to make a full recovery, and it is not unusual to have intermittent pains and aches during that time.