Ankle Fusion is an end stage operation for patients who are suffering from severe ankle arthritis or have a severe ankle deformity. Ankle fusion is a serious operation taking as long as three to five hours. A patient must be aware of and have all their questions answered before undergoing an ankle fusion. I have included a list of five questions to ask yourPodiatrist or Orthopedic surgeon before undergoing an ankle fusion.
1. How many of these ankle fusions have you performed? How many have you fused in the last year? Ankle fusion is a an extremely complicated operation. You need a surgeon who is competent in the operation. The person must have experience performing this operation regularly. Ideally, your surgeon has performed at least ten ankle fusions a year. If the answer is less and the experience is limited I would advise you not to have the operation performed by that surgeon. Also, I would lean towards having an Ankle fusion performed in an academic setting if possible. A surgeon with residents to assist in the operation and managing your hospital stay postoperatively is superior to a surgeon who does not have that luxury when performing the ankle fusion.
2. What is your re-operation rate on Ankle fusions? Ankle fusions are a high risk operation and there is a decent chance of infection as well as non union. These conditions may in some circumstances require a re-operation. Do not exclude a surgeon that has a low number of re-operations as things happen. However, those with high re-operation rates or infection should probably be avoided.
3. Have we exhausted conservative therapy? There are countless numbers of ankle braces to help with deformities and ankle arthritis. Once you have the ankle fused there is no going back. This is a serious operation. Six months to a year of conservative therapy should be attempted before having the ankle fused. That should include physical therapy or ankle bracing.
4. What kind of fixation will you use? There are multiple ways to fixate an ankle. The surgeon could use external fixation, internal fixation or a nail. Each form of fixation has its positives and negatives. The ideal way to ask this question is after he answers, ask him why he chose that fixation? Listen to the answer to make sure it is well thought out. You want a surgeon who is choosing the fixation because of your case, not the company that bought him dinner last night.
5. How long will I be in the hospital? This can be as long as a week to two weeks. Also, ask questions about the rehab used in the therapy. This is a serious operation and can take a long time to recover from. Do not be afraid to ask about rehab and the entire post operative process as you want a surgeon with a plan. In some ways the post operative phase of this operation is as important as the operation itself. Good luck in having this operation. I wish you the best. And feel confident that if you ask the right questions and choose the right surgeon, you will be fine.