The subtalar joint is found beneath the ankle joint. It is the joint at which the talus bone, which connects the foot to the ankle, meets the calcaneus bone, also known as the heel bone. The joint permits the foot to make sideways motions, which is particularly important when walking on rough or uneven surfaces. The most common reason for a subtler fusion is a severe arthritis of the joint. This often is result of a bad fracture of the talus or calcaneus, resulting in a damaged joint and arthritis. Inflammatory condition such as rheumatoid arthritis can also result in a painful joint.
Subtalar fusion, or arthrodesis, is a surgical procedure used to fuse the calcaneus to the talus. The primary goals of subtalar fusion are to decrease pain and swelling in the hindfoot, maximize stability and improve the overall function of the joint.
The Subtalar Fusion Procedure
When the joint is arthritic it loses cartilage. This decreases motion of the joint, but what little motion remains is painful because bone rubs on bone. Fusion of the joint eliminates this painful grinding. Although the joint is fused, there is little loss of motion because the arthritis has produced a significant loss already.
The procedure is usually performed with an open technique.To access the subtalar joint, the surgeon will typically create an incision on the outer side of the foot. The structures of the joint will be examined, cartilage is removed and any existing deformity is addressed. The bones are then surgically joined together using screws to stabilize and align the bones. Imaging is used during the subtalar fusion procedure to determine correct alignment and positioning. In some cases, a bone graft is incorporated as well.
Recovery from Subtalar Fusion
During the first few weeks after surgery, patients must rest and keep the leg elevated to control swelling and allow the incisions to heal. Patients should avoid placing weight on the foot, and may need to wear a boot or cast for several weeks once the surgical dressings have been removed. The boot or cast may be worn up to 12 weeks.