Saturday, October 01, 2016

N/A Triple Arthrodesis

Information provided by Foot Care MD

What is triple arthrodesis?

Triple arthodesis is used to address many types of foot deformity and pain. This procedure fuses three joints in the back of the foot. These joints are the talonavicular (blue arrow), subtalar (red arrow) and calcaneocuboid (green arrow). Surgeons try to avoid fusions, but sometimes pain and deformity are so severe that this procedure offers the best chance of producing a less painful foot with better alignment. Fusions often improve stability and allow for easier standing and walking. The triple arthrodesis is a time-tested, durable procedure. Triple arthrodesis is indicated for severe arthritis, instability or deformity that cannot be controlled with nonsurgical approaches. Other conditions, such as severe flatfoot, abnormal connections between bones, excessively high arches and joint instability due to neuromuscular disease, can also warrant treatment with fusion.

General Details of Procedure

Two incisions are generally required for this procedure. The traditional method involves one incision on each side of the foot. Within each joint cartilage is removed, bony surfaces roughened, and defects filled. Once all three joints have been prepared, they are put into place and hardware is placed to stabilize the reconstruction and promote healthy fusion.

The surgeon confirms proper position of the bones with an X-ray while in the operating room. Then all incisions are closed and covered with bulky dry sterile dressings. To lessen post-operative pain, the nerves around the knee or ankle may be numbed with medication.

The rate of healing is variable and is influenced by many factors. In general, the foot is kept elevated with no weight on it for the first two weeks to minimize swelling and allow healing of the skin. Stitches may be removed two to three weeks after surgery.

Different weight bearing protocols may be used. After signs of healing are noted, progressive weight bearing is allowed until full weight bearing is reached. This typically takes three months. A removable boot may be used rather than a cast.

My Thoughts

I guess walking around on a torn tendon for three plus years wasn't such a good idea after all. The left ankle has started to rotate inwards putting stress on the arch and the outside of my foot. I wear a brace when I plan on a lot of walking, and that helps. The greatest concern is if the tendon lets go or rolls totally down towards the arch.  The damage will not be able to be corrected unless I get a total ankle fusion, I'm not ready for that. So, I'm biting the bullet and having this surgery done to get me back up to speed and correct the alignment. I'll still have up down movement just very limited to no side movement.

I plan to finish my current consulting gig in late November so surgery will be my early December birthday present, yippie. If I heal quickly and can get back to weight bearing the client wants me back for the building construction phase in March. I'm flattered that they will even consider providing a field person to ease the stress on the leg and let me manage the project only. My goal is to once again do both, field inspection and project manage. Let's not forget how hard headed I am.

Of course this leaves me grounded for a few months which opens a whole different can of worms. I'm concerned about letting 08Romeo sit, so, I'm trying to find someone to fly her once every two weeks. An alternate plan is to add in some cam guard and fly it like I stole it before surgery then plug in the battery maintainer and wait. Many topics for discussion at annual this year, which is just around the corner. More info to follow after annual.


Jim and Sandie said...

In 2008, I fell coming out of our fifth wheel and broke my ankle and ruptured my Achilles tendon. So I have a great deal of sympathy for you and the prospect of surgery. I have a couple of screws in my ankle and spent four months in casts. I do really good with it now except for steps. The ankle just doesn't quite work normal so I usually take the steps one at a time when I'm going down. My doc told me the best therapy was to walk. Please keep us updated on how you're doing. And hopefully you find someone to help you out with 08Romeo. You have a great employer but that's because you must be a fantastically dedicated employee.

Gary said...

Thanks Sandie!

I'm not sure if its dedicated or just nuts. lol...I do enjoy seeing a project from start to finish, anything else seems like quitting.

I'll be posting often once I'm down to non-weight bearing status. If not for keeping me sane it will give my Bride a break. I guess this will be another retirement test. Hopefully she doesn't smother me with a pillow from me driving her crazy.....She does tell me she loves me. ;)

Chris said...

Sorry to hear about this, Gary. Good luck, both with the foot and with the airplane.

Gary said...

Thanks, Chris.

I'll be back up to speed in no time....I have a local CFII that may be flying 08Romeo every few weeks. I will be working on getting him on my insurance.