Midfoot Fusion

Introduction

Tarsometatarsal joints are the small joints in the middle foot. Osteoarthritis, rheumatoid arthritis or some unknown conditions may damage the tarsometatarsal joints. The joints may wear out, collapse, cause severe foot deformity and affect the function of the foot. Tarsometatarsal joint fusion is a surgical procedure that fuses the bones of the middle foot and stiffens it to correct deformities in the tarsometatarsal region.

Indications

Midfoot tarsometatarsal joint fusion is indicated when conservative approaches such as medications, steroid injections, activity modification, custom orthotics, and modified footwear fail to provide pain relief. The fusion can treat foot deformity, arthritic tarsometatarsal joints, as well as correct the front and back (rear) area of the foot.

Procedure

Midfoot tarsometatarsal joint fusion is performed under the effect of general or regional anaesthesia. Your surgeon will make 3-4 cm long cuts on the upper or inner surface of the foot. Mr Limaye will open the joints, remove the joint surface, reshape it and correct the deformity. The joints are then fixed and kept in place using screws, plates and staples. During the fusion your surgeon may add bone grafts to fill the gaps between the joints if necessary. This procedure stabilises the joints, prevents movement and provides pain relief.

Post-surgical care

After the surgery, keep the operated foot elevated to decrease swelling. After the swelling has reduced, the foot will be put into a plaster cast from knee to toes for about 8 to 12 weeks until the bones have fused. You may have to use crutches for a few weeks. Your physiotherapy will guide you to walk without putting pressure on the operated foot. Avoid driving and vigorous exercise for a few weeks after surgery. Follow-up X-ray images will be taken to check for bone fusion.

Risk and complications

As with any procedure, midfoot tarsometatarsal joint fusion involves certain risks and complications. They include:

• Infection and swelling
• Non-union of bones
• Nerve injury
• Malposition of the fused bones
• Loosened pins and screws
• Rarely, deep vein thrombosis or pulmonary embolism