Our Summary

This research paper discusses the different surgical approaches used to access the subtalar joint, which is a joint in the foot. The subtalar joint can be affected by several foot conditions, requiring surgery. Traditionally, surgeons use the lateral approach (from the side) which provides a good view of the joint. However, this method can pose some risks, especially when treating a foot deformity called hindfoot valgus. This research suggests that an alternative method, the medial approach (from the inner side of the foot), could be safer and more efficient, particularly when performing double fusion surgeries in patients with flat feet. The authors review existing research on the use of the medial approach for subtalar joint surgeries.

FAQs

  1. What is the medial approach for subtalar joint surgery and when is it used?
  2. What are the risks and limitations of the conventional lateral approach in subtalar joint surgery?
  3. Can you explain the terms “double fusion” and “triple fusion” in the context of subtalar joint surgeries?

Doctor’s Tip

A doctor might tell a patient undergoing joint fusion to follow their post-operative care instructions carefully, including keeping weight off the affected joint as directed, attending physical therapy sessions, and avoiding activities that put excessive stress on the fused joint. This will help ensure proper healing and optimal long-term outcomes.

Suitable For

Patients who may be recommended joint fusion include those with hindfoot valgus deformities, pes planus deformities, and pathologic conditions of the hindfoot that require surgical access to the subtalar joint. Double fusions and triple fusions may also be considered in certain cases.

Timeline

  • Before joint fusion:
  1. Patient experiences chronic pain, stiffness, and instability in the affected joint.
  2. Patient may undergo conservative treatment options such as physical therapy, medications, and injections to manage symptoms.
  3. If conservative treatments are ineffective, patient may be recommended for joint fusion surgery.
  4. Patient undergoes pre-operative evaluations and consultations to assess their overall health and suitability for surgery.
  • After joint fusion:
  1. Patient undergoes joint fusion surgery, where the bones in the affected joint are fused together to create stability.
  2. Patient experiences post-operative pain, swelling, and limited mobility in the initial recovery period.
  3. Patient undergoes physical therapy and rehabilitation to regain strength, range of motion, and function in the fused joint.
  4. Over time, patient gradually experiences improved pain relief, stability, and function in the fused joint.
  5. Patient may need to make lifestyle modifications to accommodate the limitations of the fused joint, such as avoiding high-impact activities.
  6. Long-term follow-up care is required to monitor the fused joint for any complications or issues that may arise.

What to Ask Your Doctor

  1. What is the reason for recommending joint fusion in my case?
  2. What are the potential risks and complications associated with joint fusion surgery?
  3. What is the expected recovery time and rehabilitation process after joint fusion surgery?
  4. How will joint fusion surgery affect my mobility and ability to perform daily activities?
  5. Are there any alternative treatments to joint fusion that I should consider?
  6. How successful is joint fusion surgery in treating my specific condition?
  7. What is the long-term outlook for joint fusion surgery in terms of pain relief and joint function?
  8. How often will I need follow-up appointments after joint fusion surgery?
  9. Are there any lifestyle changes or precautions I should take after joint fusion surgery?
  10. Can you provide me with information on the surgeon’s experience and success rate with joint fusion surgeries?

Reference

Authors: Widnall J, Mason L, Molloy A. Journal: Foot Ankle Clin. 2018 Sep;23(3):451-460. doi: 10.1016/j.fcl.2018.04.006. PMID: 30097084