Subtalar fusion at Cambridge Hospital

Your subtalar joint sits just below your ankle joint. Where your ankle joint only allows for up and down movement, your subtalar joint allows your foot to move in circulator rotations and side to side making walking on uneven surfaces possible. Over time the bone surfaces in your subtalar joint can suffer wear and tear due to injury or arthritis.

What happens during subtalar fusion?

Subtalar fusion is usually performed under general anaesthetic. It usually takes about 90 minutes. Your surgeon will make an incision (cut) on the outside of your ankle. They will clean and clear any damaged joint surfaces and fix your joint together using one or two screws through the back of your heel. You will not feel the screw and it does not need to be removed. 

Subtalar fusion is sometimes performed arthroscopically. Be sure and discuss what method will be used with your surgeon. 

Your ankle will have a cast applied immediately following surgery. You may have a small tube (drain) in your wound to drain any excess fluid.

After your subtalar fusion

You may be in hospital one to two nights. Please let our Healthcare Team know if you are in any pain. 

You should not put your weight on your fused ankle for six to 12 weeks following surgery. Our physiotherapists will visit you to teach you how to move around with a walker or crutches. They will work with you to ensure you are moving about on your own before you are discharged.

Going home after subtalar fusion

Your subtalar joint needs to be fully fused before you can drive. Please arrange for someone to take you home and look in on you in the first few days. You should rest and keep your leg elevated to control swelling. After 10 to 14 days you will need to come back to have your stitches removed. You may be given a lighter weight cast. 

Be sure and take any pain medications as directed. 

Your surgeon may schedule regular x-rays to assess the extent of fusion. As the fusion gets stronger you may be allowed to start putting weight on your foot. You might need to work with a physiotherapist to learn to walk without a limp. 

You should plan on at least 10 to 12 weeks of recovery before returning to normal activities. Be sure and discuss any return to work with your surgeon. It can take up to one year to feel the full benefits of subtalar fusion. 

Most patients make a good recovery from subtalar fusion. You should discuss returning to any sport or other rigorous activities with your surgeon. 

Any surgical procedure can result in complications:

• Pain
• Bleeding
• Infection
• Blood clots (DVT)

Specific complications of ankle fusion:

• Nerve damage
• Numbness
• Nonunion (lack of fusion)
• Malunion (displaced healing)