Are you tired of having severe pain in your leg, specifically in the heel? Does this pain bother you not only when walking, climbing stairs, but also when just standing? You may have tried many treatments. If so, this article will be very important for you. Today we will talk about a special surgery that will bring a permanent solution to such severe leg pain.
Simply put, what is Subtalar Fusion?
Subtalar Fusion is a surgical procedure that permanently joins two bones in a joint in your foot. Another name for this is ``arthrodesis'' by doctors.
Now let's see where this joint is located. In your foot, just below the ankle joint, where the heel bone `(calcaneus)` and the ankle bone above it `(talus)` connect, this joint is called the `(subtalar joint)`. This joint is what helps your foot turn in and out. Therefore, this joint is very important for you to walk and run with balance.
So why do we need surgery on this joint? The main reason is severe arthritis . Arthritis causes the cartilage (the cushion-like part that prevents two bones from rubbing against each other) inside our joints to wear away. Then the two bones start rubbing against each other. Imagine how much pain it must be when two bones are always rubbing against each other. To relieve that pain, doctors insert screws into these two bones and fix them as one. This is called ``Subtalar Fusion''.
A doctor usually recommends this surgery when other treatments, such as painkillers, injections, and physical therapy, have failed to provide relief.
What happens before the surgery?
After you decide to have surgery, you will have several meetings with your doctor and surgeon. They will ask you the following questions:
- How does this pain affect your daily life?
- What treatments have you had so far? How much relief have they provided?
It's important to be very honest here. It's normal to feel a little scared when you're told about surgery. But don't minimize your pain because of that fear. Tell your doctor honestly things like, "I can't even get out of bed in the morning because of this pain," "I don't even feel like going on a trip with friends," "I can't do the sport I used to love anymore." Then he or she can make the best decision for you.
You will be asked to have these tests before surgery:
- A complete physical examination: See if you are healthy enough to undergo surgery.
- Imaging Tests: An X-ray will definitely be done. You may also be asked to do an MRI or CT scan.
- Blood tests: Check for various things in the blood.
Be sure to tell your doctor about any medications, vitamins, or herbal remedies you are taking. You may be asked to stop taking some medications a few days before surgery. You may also be advised to fast for 12 hours before surgery.
How is the surgery done?
On the day of the surgery, you will be given anesthesia. This means you will be given medicine to make you feel no pain. You may be put completely to sleep (general anesthesia) or you may only be numbed in your leg (regional anesthesia).
During the operation, the surgeon will fuse the two bones in your foot together.
Most of the time, this is done as an open surgery. That means,
1. The doctor will make a small cut in the skin where the affected joint is located on your foot.
2. Then, worn-out and damaged cartilage and bone fragments are removed.
3. Next, the two bones are placed together and special metal screws are inserted through them to secure them together.
4. Finally, the incision is sewn back shut.
Some people can also have this surgery done through a single incision called an arthroscopy. In this, instead of a large incision, only two or three small incisions are made. A camera-equipped device called an arthroscope is inserted through that incision and the surgery is performed while being viewed on a monitor. Your doctor will decide which of these two methods is best for you.
This surgery usually takes about two hours .
What happens after the surgery? And what are the pros and cons?
This is often a day surgery and you can go home. After the surgery, you will be put in a special boot or brace to keep your leg immobile and to prevent weight bearing on your leg. You will be told to use crutches for a few weeks and to keep your leg elevated as much as possible.
| Advantages | Risks/Disadvantages |
|---|---|
| Great relief from pain: The biggest benefit is that the severe pain that plagued your daily life is almost completely gone. | Nonunion: Rarely, the two bones that were fixed with screws may not come together as expected. If this happens, further surgery may be required. |
| Improved quality of life: Once the pain is gone, you can return to your work, exercise, and walk wherever you like. | Reduced range of motion: Since two bones are fused into one, the ability to turn the foot in and out may be somewhat reduced. However, this is not a major problem when compared to the severe pain. |
| A safe and successful procedure: This is considered a safe surgery with very successful results. | General surgical risks: The risks of any surgery, such as infection, excessive bleeding, and reactions to anesthesia, are also present here. |
How long will it take to heal? Will I be able to walk again?
Yes, you can definitely walk, run, and be normal again. In fact, you will be able to walk more comfortably than before because you will be pain-free!
It takes several months to fully heal. It takes between 8 and 12 weeks for the two bones that were fused together to fuse together and become strong. During this time, you will need physical therapy . A physical therapist will help you learn how to properly use your leg again, including weight-bearing and exercises. It is usually best not to put weight on your leg for a month or two.
At what time do you need to see a doctor immediately?
After you go home after surgery, if you experience any of these symptoms, you should call your doctor immediately .
- Having a fever of more than 101 Fahrenheit (39 Celsius).
- Signs of infection in the surgical wound (e.g., pus-like fluid draining from the wound, swelling, discoloration, a foul odor, or warmth to the touch).
- Instead of decreasing the pain, it increases again.
- Excessive bleeding from the wound.
This surgery is 85% successful. That means that 85 out of 100 people experience significant pain relief and a good recovery. If your foot pain is not responding to other treatments, don't be afraid to talk to your doctor about this surgery. It could make a big difference in your life.
Take-Home Message
- Subtalar Fusion is a successful surgical procedure for foot pain caused by conditions such as severe arthritis.
- This involves permanently fusing two bones together in the heel and ankle.
- The main benefit of this surgery is the great relief from unbearable pain.
- It takes several months to fully recover after surgery, and physical therapy is essential.
- Although the movement of the leg is somewhat limited after surgery, being able to walk without pain is a much greater advantage.
- Talk openly with your doctor about your condition and whether this surgery is right for you.
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