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Patient Education: Foot & Ankle |
| THE PROBLEM
Arthritis of the ankle means the smooth surface that covers the
end of the bone (the "cartilage") has been lost and there
are usually bone spurs around the joint. This often occurs after
an injury or from diseases like rheumatoid arthritis, but it sometimes
happens without any known cause. There are three choices for treating
ankle arthritis:
- Do nothing or wear a plastic brace for comfort
- Ankle fusion (making the two bones grow together).
- Ankle replacement (in some patients).
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| THE SURGERY
Ankle fusion makes the tibia, or shin-bone, grow together with the talus,
the bone immediately under it. This stiffens the ankle. You lose much
of the up-and-down motion of the back of your foot, but you still have
some from the other joints around the ankle. In addition, you will still
have the side-to-side rocking motion that comes from the joint below the
ankle. Ankle fusion is about 95% successful in getting the ankle bones
to grow together. Once healed, the fusion is very durable, and you can
even do heavy labor with the foot. Most patients walk without a limp and
get excellent relief of pain. The downside of ankle fusion is that it places extra stress on the other
joints around the ankle, and these develop at least some arthritis within
about 15 years. |
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The surgery is done through an incision
on the outside of the ankle. We usually add a very short incision
on the inside of the ankle as well. Two or more screws are put in;
they usually do not bother patients, but occasionally need to be
taken out later.
Smoking keeps bones from healing well, especially in the foot.
You should not smoke for at least 3 months. Also, if you take anti-inflammatory
medications like Advil, Naprosyn, or aspirin, stop them 5 days before
surgery. |
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AFTER THE SURGERY
One night's stay is usually required. You will have a lbulky dressing
in place. Keep your foot elevated above your heart as much as possible
for the first week. YOU CANNOT WALK ON THE FOOT. Some patients like to
practice with crutches before surgery. |
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2 WEEKS: We will take out your stitches
and put on a fiberglass cast. Keep the cast dry. If you accidentally
get a little water on it, use a blow dryer. If it is very wet, call
us.
6 WEEKS: If your X-rays show healing, we will change your cast
and let you slowly start putting weight on the foot.
3 MONTHS: Most patients can start using a removable cast boot (with
full weight on the foot).
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| 3-6 MONTHS: When your X-rays show complete healing, we will let you get
back to normal activities and shoes. The exact timing varies between patients. |
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