What is ankle fusion?

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Ankle fusion: Overview

Ankle fusion is surgery that helps to relieve pain and make your ankle more stable.

The doctor makes one or more cuts in the ankle to reach the ankle joint. These cuts are called incisions. The doctor uses a tool to remove the surface of the ankle joint. This prepares the joint for the next steps. Then the doctor uses screws or other hardware to align and hold the bones so they grow together (fuse). The incisions are closed with stitches or staples.

The surgery can also be done using arthroscopy. That's a way to do surgery inside a joint without making a large incision. Your doctor puts a lighted tube through small incisions in your ankle. The tube is called an arthroscope or scope. Next, the doctor puts some surgical tools in the scope to help make needed repairs. Then the doctor stitches the incisions closed. You will have scars, but they usually fade with time.

You will stay in the hospital for about 2 days after surgery.

In about 10 to 14 days, the doctor will take out the stitches.

You will go home wearing a cast or a walking boot. The doctor will tell you when you can start to put weight on your ankle. It most often takes at least 6 to 8 weeks. You may need physical therapy (rehab). You will need to use crutches, a walker, or a knee scooter during your recovery.

After surgery and rehab, you will probably have less pain and more strength and movement in your ankle.

How can you care for yourself after an ankle fusion?

Activity

  • Rest when you feel tired.
  • Avoid putting weight on your ankle until your doctor says it is okay.
  • You may shower 24 to 48 hours after surgery, if your doctor okays it. When you shower, keep your dressing and incisions dry. If you have a cast, tape a sheet of plastic to cover it so that it does not get wet. It may help to sit on a shower stool.
  • If you have a removable splint, ask your doctor if it is okay to take it off to bathe. Your doctor may want you to keep it on as much as possible. Be careful not to put the splint on too tight.
  • You will probably need to take at least 2 to 4 weeks off from work. It depends on the type of work you do and how you feel.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have a splint or cast, follow your doctor's instructions. Keep it dry. Do not put anything, including powder, between the splint or cast and your skin.
  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off. Keep the area clean and dry.
  • If you had stitches, your doctor will tell you when to come back to have them removed.

Exercise

  • Ankle rehabilitation is a series of exercises you do after your surgery. This helps you improve your ankle's range of motion and strength. You will work with your doctor and physical therapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you.

Ice and elevation

  • Put ice or a cold pack on your ankle for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin. If your doctor recommended cold therapy using a portable machine, follow the instructions that came with the machine.
  • Prop up the sore leg on a pillow when you ice it or anytime you sit or lie down. Try to keep it above the level of your heart. This will help reduce swelling.

Other instructions

  • You will need to use crutches, a walker, or a knee scooter after surgery for about 6 to 8 weeks. Your doctor will tell you when you can put weight on the ankle. It may help to use a backpack or wear clothes with a lot of pockets to carry items.

How do you prepare for ankle fusion surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After ankle fusion surgery: Overview

You had ankle fusion surgery to treat a painful, unstable ankle. When you leave the hospital, you will wear a cast or walking boot. And you will use crutches or a walker to keep your weight off your ankle.

After surgery, you can expect your ankle to feel stiff and sore around the area where your doctor made the cut (incision). Your doctor will give you medicine for the pain.

Your doctor may give you specific instructions on when you can do your normal activities again, such as driving and going back to work.

What happens on the day of ankle fusion surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery will take about 1 to 1½ hours.

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