A Transverse Tarsal Arthrodesis is a procedure to treat tendon ruptures, severe flat foot deformity and hindfoot arthritis. It involves fusion of the one or two of the joints of the transverse tarsal joint including the talonavicular, the calcaneocuboid, or both. Tendon balancing and bone grafting procedures are performed with this surgery to improve results. Pain relief in this type of operation is excellent. Gait improves significantly because of decreased pain, although 20 percent of up-and-down motion and all of side-to-side motion is lost. The surgery may be performed on an inpatient or outpatient basis depending on your particular needs.
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For more information about Tranverse Tarsal Arthrodesis, keep reading.
What Happens Before Transverse Tarsal Arthrodesis?
The surgical center will provide you with individualized information on how to prepare in the days leading up to surgery. On the day of surgery, your anesthesiologist will administer regional anesthesia known as a Popliteal nerve block. You will be placed on your stomach and a small needle will be used to inject novocaine-like medication around the nerve in your leg. It gives complete pain relief through surgery, and it wears off after 12 to 36 hours. Patients report astonishing satisfaction with this type of anesthesia. You will also be given antibiotics just before surgery to help prevent infection.
What Happens During Transverse Tarsal Arthrodesis?
During the surgery you will be put into a relaxed state by the medication delivered through the I.V. A tourniquet will be placed around your calf, but you won’t feel the pressure because of the nerve block. Incisions will be made along the inside and outside of your foot, inside of the ankle, and back of your leg. The involved joints have their surfaces roughened to imitate a fracture. The foot is then repositioned to recreate an arch and balance it beneath the leg. Screws and bone staples are used to hold the bones in place while they mend. X-Rays are taken during surgery to confirm the correction of the foot misalignment. Finally, the wounds are closed with stitches and staples, and the patient is taken to a recovery room.
What Happens After Transverse Tarsal Arthrodesis?
You will be permitted to leave the surgical center once your anesthesiologist is satisfied that you have recovered. Depending on your needs you will be admitted to the hospital for a short stay or discharged home. If you are having outpatient surgery, your family member may take your prescription to the nearest pharmacy while you recover. Your foot will be placed in a sterile protective splint. You will also be given crutches. Take your narcotic pain control medications before falling asleep or as you feel the “numbing” effect wear off. Remember, postoperative pain is much easier to control with prevention as opposed to treatment.
Transversal Tarsal Arthrodesis General Recovery Timeline
This timeline is a general guideline. Your post-operative course may vary.
| First 2 Weeks | Elevation is critical during the first two weeks after an ankle operation. You are encouraged to move your toes during this time period. This will decrease foot swelling and improve wound healing. However, do not put any weight on your foot until Dr. Silverman tells you it’s okay. You are encouraged to use narcotic pain control medication for pain. |
| 2 Weeks | You should return for a post-op visit approximately 14 days after your surgery. Your splint and sterile dressing will be unwrapped and stiches will be gently removed. X-rays will be taken. You will be placed in a cast to help control swelling, stabilize and protect the ankle while the bones heal. Do not put any weight on the foot until Dr. Silverman tells you its okay.
Weight-bearing too soon risks breaking the hardware, fracturing the bones or tearing the tendons and ligaments. You may shower or bathe, but do not get the cast wet. Pain should decrease significantly. Patients with left-sided surgery may drive cars with automatic transmission. Patients with right ankle surgery must wait until adequate healing and strength returns. You may return to work if you have a sit-down job. |
| 6 Weeks | X-rays will be taken. A cast-brace should be worn all day to protect the bones as they mend. Continue using the internet directed rehabilitation. Weight bearing will still be restricted. Most patients can begin to bear partial weight on the heel after 8 weeks. If you have pain, do not advance. |
| 12 Weeks | X-Rays will be taken. Physical therapy (2-3 sessions per week for six weeks) is often required to regain ankle and foot strength. Your overall comfort level improves significantly over the next few months and continues throughout the rest of the year. (It takes a while for your body to get used to your new foot.) You may discontinue use of your brace when given permission by Dr. Silverman. |
For more helpful tips, check out these rehab exercise videos that will help you recover, or reach out to Dr. Silverman for more information!