Tibiotalocalcaneal Fusion

What is Tibiotalocalcaneal Fusion?

Tibiotalocalcaneal (TTC) fusion is a surgical procedure used to treat severe ankle and hindfoot arthritis, instability, or deformity. This procedure fuses the ankle joint (tibiotalar joint) and subtalar joint (talocalcaneal joint) together, providing stability and pain relief.

Why is Tibiotalocalcaneal Fusion Performed?

Tibiotalocalcaneal fusion is typically recommended for patients with advanced arthritis or other conditions that have not responded to conservative treatments such as medication, physical therapy, or orthotics. Some of the common conditions that may lead to tibiotalocalcaneal fusion include:

• Post-traumatic arthritis

• Osteoarthritis

• Rheumatoid arthritis

• Ankle instability

• Flat feet

What happens during surgery?

During TTC fusion surgery, you will be given general anesthesia or regional anesthesia to numb your lower leg. Your surgeon will make an incision over the ankle and remove any damaged cartilage. Depending on the severity of condition, your surgeon may attempt to do this through key hole surgery. Then, they will position the bones in the correct alignment and use screws, plates, or other hardware to hold them together while they fuse. The incision will be closed with stitches or staples.

What can I expect after surgery?

When you wake up, you will have a plaster splint over your ankle. Do not take this off and do not get it wet. You will be seen 2 weeks after surgery at which time your surgeon will remove your staples and the plaster slab. Your ankle will then be placed in either a fiberglass cast or an Airboot. You will also be given a prescription for painkillers and antibiotics.

After surgery, you will need to wear a cast or boot and avoid bearing weight on the ankle for at least 12 weeks to protect the ankle and promote healing. You will also need to keep your leg elevated as much as possible for several weeks. You may need to use crutches or a walker to get around.

When can I return to work?

The recovery time after a TTC procedure can vary from patient to patient depending on the extent of the injury and the type of work you do. In general, most patients can return to work within 3-4 months after the surgery, although some may require more time off if their job involves heavy physical activity or standing for long periods of time.

It is important to follow your surgeon's instructions regarding your post-operative care, including proper wound care, physical therapy, and activity restrictions. Your surgeon may also recommend that you modify your work duties or take time off if necessary to allow for proper healing and rehabilitation.

It is important to remember that every patient is different and recovery times can vary. It is essential to communicate with your surgeon and follow their recommendations to ensure a safe and successful return to work.

What are the risks and complications of TTC fusion?

As with any surgery, TTC fusion carries risks and potential complications, including:

• Infection

• Bleeding

• Nerve damage

• Blood clots

• Failure of the bones to fuse

• Nonunion or malunion of the bones

• Joint stiffness or limited mobility

• Chronic pain
  

Your surgeon will discuss the risks and benefits of ankle fusion with you before surgery and answer any questions you may have.

Summary:

Tibiotalocalcaneal fusion is a surgical option for patients with severe ankle and hindfoot conditions. This procedure can help to provide stability and pain relief, but it is important to carefully follow your surgeon's instructions during the recovery period to ensure the best possible outcome.