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A triple arthrodesis is a procedure in which three of the bones in the foot are fused together with the insertion of stabilizing structures such as screws. This can help strengthen the foot and ankle, and is usually performed in cases wherein there is a natural deformity of the bones or in the shape of the foot that causes pain or difficulty walking. The procedure was first performed in the early 1920s.
The three joints that are fused are those that are responsible for allowing side to side movement. The calcaneocuboid joint, subtalar joint and the talonavicular joints are located in the heel and back of the foot. When there is a deformity or injury, the weight of the individual is not borne properly on the ankle and foot; in severe cases, this can result in an easily visible shift in the bones of the foot and leg.
Joints involved are located below the ankle. A triple arthrodesis will require two surgical incisions that allow the medical professional to reach the cartilage between the bones. Typically the first step in the surgery is to remove this cartilage. This allows the surgeon freedom to reset the angle of the foot and correct the way in which the individual's weight is carried. Once this angle is corrected, the joints are fused together using permanent fixtures, such as staples, wires or screws.
Individuals with severe arthritis pain caused by weak joints in the feet can be candidates for a triple arthrodesis. In some cases, those suffering from different forms of paralysis can also find increased movement with a combination of the surgery and physical therapy. A triple arthrodesis is also frequently performed on children suffering from a variety of conditions, including cerebral palsy, poliomyelitis, tuberculosis or a club foot. Generally, most patients have some form of degenerative disease in which the function of the foot will get worse over time but can be strengthened with the removal of the cartilage between the joints. In some cases, these conditions are brought about by fractures of the bones in the heel, which weaken the weight-bearing area of the foot.
Occasionally, one of the three joints will not fuse correctly and another surgery may or may not be required. This is relatively rare, however, and the overall prognosis for the surgery is good. Many who undergo this surgery regain the ability to function on at least a somewhat normal basis. High-impact exercise and activity are not recommended in some cases, but most people can walk and move normally. The recovery process after a triple arthrodesis can take up to a year.
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