Mid foot fusion surgery is something that is done in cases of pain and discomfort due to the presence of arthritic joints in the foot. The area in question is the midfoot, or the part of the foot that forms the arch. It connects the toes to the heel.
A surgery in this area is advised only if previous attempts at trying to heal the problem through non surgical means have failed. As the name implies, the attempt is to fuse together one or more bones of the area. The decision as to how many bones will be fused depends upon the surgeon and an estimation of the extent of the involvement of various joints.
The procedure involves a couple of incisions on the top of the foot after adequate anesthesia has been achieved. The extant will vary with the number of bones involved. The surgeon will then remove all of the cartilage the forms the joint between the bones as it will hamper any new bone formation. Any gaps that appear after the removal of this cartilage then will be filled with the use of bone graft.
The most ideal kind of bone graft is autogenous bone graft (bone taken from another part of the body), however it can be sometimes to get sufficient quantity and involve creating a second surgical site. Xenograft (prepackaged sterile bone from animal sources) is also a good option to be used in these surgeries.
Immobilization after the procedure has been completed is essential and key to allowing the bone to form. If there is too much mobility then there will be no bone formation.
Apart from the usual risks associated with any surgical procedure, there are a few more that need to be considered. The area of the foot is densely populated by important tendons and nerves that can be damaged during the procedure. This can affect the mobility of the foot in a permanent manner.
Any infection at the site of surgery can prevent the uptake of bone graft and can lead to a failure of the entire procedure. There is also the risk that more or less than necessary cartilage is removed leading to a deformation and difficulty in union.
Post Operative Care
This is probably the most important phase of the entire procedure since it determines whether the procedure is a success or not. There will be a cast fit on your foot to prevent mobility and to ensure that the foot does not bear any weight. The use of a pre fabricated boot to prevent any undue pressure on the foot may also be done.
The period of immobilization lasts from 12-16 weeks under normal course.
The procedure is invasive in nature and carries with it risks for potential complications, however it has been proven to provide long term relief to patients. There is no harm in considering this procedure if your doctor advises you for it and other non surgical methods have not yielded any impact.
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