Triple Fusion Arthrodesis | Dr Christy Graff

Fusion (Arthrodesis) of the Hindfoot (Triple Arthrodesis) Surgery

The surgery involves making the affected joints into one bone
The bones need to be held in this position with fixation, which can be plates, screws, bolts or an external device (circular frame)
Sometimes bone graft from another part of the body (often the pelvic bone near the hip) is used as bone graft to help the bones fuse; artificial bone graft is also used
X-rays are used in theatre to make sure the bones are aligned correctly, and there is a tourniquet placed around the thigh to help with bleeding

The surgery can take 90 to 180 minutes.

Unless you have a circular frame, you wake up with a half plaster (backsLab) or a boot
Your foot will be elevated overnight, and you have antibiotics through a drip
You will need blood thinners to prevent DVT You will vitamin C to help with pain management and wound healing
You will stay in hospital for 2-5 days with antibiotics, blood thinners, regular paracetamol, regular laxatives, regular vitamin C and stronger pain killers to take if and when required
You will be only allowed to touch your foot to the ground for 6 weeks
Depending on your balance and strength, you may need rehabilitation post operatively
Buying a second hand knee scooter pre operatively (can search online) and practicing at home before the surgery, can be helpful; please bring it into the hospital with you. It is easier to use a knee scooter than crutches

You will need medications for pain relief; regular paracetamol (2 tablets four times a day) is recommended, as well as strong pain killers, especially at night before bed. These can have side effects of drowsiness, nausea and constipation, and other tablets to help with these side effects may be required.
You will need blood thinners and vitamin C as prescribed
You will need a shower chair and bags to keep the plaster / boot dry
You will need to attend your post op appointment in 2-3 weeks where the wounds will be checked and your plaster changed to a waterproof cast if your wounds are healed
After this you will be able to shower with a shower chair and get the plaster wet

ALL patients are different. These timelines are only a guide, and some patients may progress faster or slower than others.

Backstab or boot full time for 2-3 weeks
Touch weight bearing only
Strict elevation on 3 pillows and only mobilise or essential things like toileting
Bag the leg for showers
Pain relief: Please take regular paracetamol with meals; stronger pain killers are often needed
Please take blood thinners as prescribed to prevent blood clots and vitamin C 500mg twice a day to help with wound healing and pain

Post op appointment for a wound review and x-ray
Full cast (often waterproof if the wounds are ok) or continue with the boot for another 3-4 weeks
Continue elevation on 3 pillows
Commence core and static strengthening and balance exercises with physio

Commence weight bearing in supportive shoes/boot with a rocker bottom if swelling allows
Swelling management with elevation, compression and ice
You can start swimming and cycling

If x-rays show satisfactory fusion of the bones, increase physiotherapy such as jogging and sports specific training

If you want more information or have any questions or problems, please contact Dr Graff at admin@christygraff.com or call the rooms at 0493 461 133.