Treatments

Midfoot Fusion (Arthrodesis)

Midfoot fusion surgery is a specialized procedure aimed at addressing various foot conditions affecting the middle part of the foot, known as the midfoot. This intricate surgery involves fusing together the bones and joints in the arch of the foot to alleviate pain, correct deformities, and restore stability and function.

Definition

The midfoot comprises the bones and joints that connect the forefoot (toes) to the hindfoot (ankle and heel). Midfoot fusion surgery involves the fusion of these bones and joints to eliminate abnormal motion and restore proper alignment. By immobilizing specific joints, midfoot fusion aims to reduce pain, improve function, and correct deformities that affect the foot's structure and stability.

Diagnosis

Midfoot fusion surgery is typically recommended for individuals with persistent foot pain, deformities, or instability that have not responded to non-surgical treatments. Common indications for midfoot fusion include arthritis, excessive joint motion, deformities such as severe bunions or flat feet, acute fractures, or joint displacement in the midfoot region. Candidates for surgery undergo a thorough evaluation to assess the severity of their condition and determine the most appropriate treatment approach.

Treatment

Successful midfoot fusion relies on meticulous surgical technique and careful post-operative management. During the procedure, the surgeon makes precise incisions and removes any damaged cartilage from the affected joints. Metal implants such as screws and plates are used to stabilize the bones in the desired position, promoting bone healing and fusion. Bone graft material may also be added to facilitate bone growth and stability.

Recovery

After midfoot fusion surgery, patients typically undergo a period of immobilization to allow for proper bone healing. Weight-bearing restrictions may be implemented for several weeks to months, depending on the extent of the surgery and the individual's healing progress. Physical therapy may be prescribed to improve strength, flexibility, and mobility in the foot. Follow-up appointments and imaging studies are conducted to monitor healing and assess the success of the fusion.

Risks and Complications

As with any surgical procedure, midfoot fusion surgery carries potential risks and complications, including infection, nerve or blood vessel injury, delayed healing, and nonunion (failure of bones to fuse). Over-correction or under-correction of deformities, wound healing problems, and hardware-related issues are also possible. Patients should be aware of these risks and work closely with their surgeon to minimize complications and optimize outcomes.

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Frequently Asked Questions

How will my walking change after midfoot fusion?

Midfoot fusion aims to decrease pain and improve function by eliminating abnormal motion in the affected joints. While there may be some stiffness in the toes following surgery, the loss of motion is typically well-tolerated, and walking ability may improve as pain diminishes.

How will I get around after surgery when I can't put any weight on my foot?

Patients may use assistive devices such as crutches, walkers, knee scooters, iWalk, or wheelchairs to navigate while keeping weight off the operated foot. Physical therapy may be beneficial in improving mobility and safety during the recovery period.

Will the plates and screws have to be removed after midfoot fusion?

Metal implants are usually not removed unless there are specific complications such as fusion failure or infection. Painful hardware may be removed once the fusion is healed and no longer necessary.

How long will I be out of work?

The duration of time off work varies depending on the individual's job requirements and the extent of the surgery. Return to work timelines are determined based on factors such as pain management, weight-bearing restrictions, and overall healing progress.

Will I set off an airport metal detector after midfoot fusion?

Metal implants used in midfoot fusion surgery are typically undetectable by airport security measures. However, the detection of hardware depends on various factors such as the strength of the metal detector and the type and amount of metal implants used.

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