Arthrodesis - wrist/ankle subtalar

Arthrodesis refers to joint fusion surgery. It is recommended to patients who have severe arthritis-related pain in their joints.

As its name suggests, joint fusion surgery fuses two independent bones to make it one solid bone, thus relieving the pain for the patient.

What is Arthrodesis - wrist/ankle subtalar?

Arthrodesis refers to joint fusion surgery. It is recommended to patients who have severe arthritis-related pain in their joints.

 As its name suggests, joint fusion surgery fuses two independent bones to make it one solid bone, thus relieving the pain for the patient.

 The procedure stabilizes the joint and may improve the weight-bearing capacity of the joint. 

Arthrodesis is recommended when the damage caused to a particular joint debilitates the patient. Joint fusion surgery is done for the following joints:

  • Feet

  • Ankles

  • Wrist

  • Thumbs

  • Fingers

  • Spine (vertebral column)

It may be performed to relieve the symptoms of certain degenerative diseases such as scoliosis. 

While recommending the surgery, the doctor also considers factors such as the patient's mental preparedness to cope with a long duration recovery. 

What are the risks involved in Arthrodesis - wrist/ankle subtalar?

  • Infection

  • Compromised bone quality

  • A neurological condition which will hinder the recovery

  • Narrowed arteries

How the Surgery is done?

The joint that is operated on decides if it will be an outpatient surgery, (the patient is sent home the same day) or it will include a hospital stay. 

The choice of anesthesia too is decided by the joint that is being operated. Depending on the joint, the doctor will decide the anesthesia will be local or general. 

Under local anesthesia, the patient will be drowsy but awake throughout the procedure, whereas in general, the patient will be in deep sleep during the procedure. 

Once the anesthesia has taken effect, the doctor makes an incision on the skin to access the bone in the joint. The damaged bone and cartilage (tissue) are removed by scrapping. 

This leaves the bone surface slightly rough and facilitates fusing of the bone into one solid bone. 

Sometimes when the two bones, which are meant to fuse, are little spaced out than needed, the doctor will bridge it with a small piece of bone. This bone can come from the following sources:

  • Pelvic bone

  • Heel

  • Bone just below the knee

  • Donated bone from a bone bank

The doctor could also use an artificial manmade material in place of an actual bone. 

Once the bone has been prepared for fusing, the doctor uses metal plates, screws, wires if needed to hold the bones together until they fuse to become one bone. 

This hardware used is generally never removed and the material used is such that it can remain in the patient's body permanently. 

Once completed, the incisions are sutured or stapled together. 

What care should to be taken after surgery?

Over time once the bone fuses, the joint cannot be moved then. 

Until the bone completely fuses, it needs to be protected wearing a brace or a cast, as suggested by the doctor. 

The patient is not supposed to put any weight on the operated joint. Until recovery, the patient might be advised use of a walker, crutches or even wheelchair. 

After 12 weeks of the main healing period, the doctor will gradually have the physiotherapist start exercises to help cope with the mobility of the other joints, which may have gone stiff during the recovery. 

The patient will be prescribed painkillers to cope with the pain involved during the recovery. 

These need to be taken exactly as per the instructions of the doctor and discontinued when told.

Although it is a safe procedure, any discomfort should be brought to the doctor's notice immediately for effective recovery and benefit from the procedure. 

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