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In ankle fusion, an ankle is surgically fused with screws. In some cases, where a deformity is present, an external fixator can be applied to simultaneously correct the deformity and fuse the joint.
Ankle fusion surgery can be generally performed three different ways:
- Conventional ankle fusion surgery using internal fixation (generally screws and plates, rarely, via intramedullary rods)
- Minimally invasive, or arthroscopic ankle fusion
- External Fixation ankle fusion with or without deformity correction
Candidates for ankle fusion surgery may include patients with severe ankle misalignment, osteoarthritis or other ankle conditions. To relieve ankle pain when cartilage has been damaged or destroyed, the bones of the ankle can be fused. Ankle fusion surgery involves the implantation of external or internal fixation devices.
In external fixation, surgical pins are fixed inside the leg and ankle bones to keep the bones in place, and an outer metal rod and pins hold the bones in place until they heal. More commonly, in an internal fixation approach using internal fixation, the cartilage at the ankle joint is removed, and the ankle and leg bones are compressed with plates and screws so that the bones fuse. The fusion may be promoted by first inserting bone-graft material, often obtained from elsewhere in the body.
Ankle fusion may also be performed using minimally invasive arthroscopic surgery. With that method, surgeons use an arthroscope, a small camera inserted through an incision that allows the surgeon to view, diagnose and treat the joint.
After ankle fusion surgery, the screws and plates usually remain in the ankle after healing. After ankle fusion surgery, the ankle joint may have a smaller range of motion than before surgery. Other joints, if healthy, may be able to compensate for the loss of range of motion. Some patients walk so well after healing is complete that observers may not be able to tell which ankle was fused. The greater load on the other joints may eventually result in arthritis. Ankle fusion may allow for more stability and less pain than other ankle surgeries.