Name of the Procedure:

Arthrodesis, Midtarsal or Tarsometatarsal, Multiple or Transverse

Summary

Arthrodesis is a surgical procedure where two or more bones in the midfoot (midtarsal) or the joints between the foot and the toes (tarsometatarsal) are fused together. This fusion is done to eliminate movement in these joints, providing pain relief and stability.

Purpose

The procedure is primarily performed to address severe arthritis, deformities, or instability in the midfoot or tarsometatarsal joints. The goal is to relieve pain, correct deformities, and improve foot function by creating a stable, continuous bone structure.

Indications

• Severe arthritis in the midfoot or tarsometatarsal joints
• Chronic pain unresponsive to conservative treatments
• Significant foot deformities causing pain or difficulty walking
• Instability in the midfoot or tarsometatarsal joints
• Traumatic injuries leading to joint damage

Preparation

• Pre-operative assessments, including X-rays, CT scans, or MRI to evaluate the extent of joint damage
• Fasting for a specified period before the procedure, typically 8-12 hours
• Possible adjustments to current medications as directed by the healthcare provider
• Pre-surgical physical examination and clearance

Procedure Description

1. Anesthesia: The patient is given general anesthesia or regional anesthesia, depending on the situation.
2. Incision: An incision is made over the affected joints.
3. Joint Preparation: The cartilage is removed from the joint surfaces to be fused.
4. Bone Grafting: Bone graft material may be placed between the bones to promote fusion.
5. Fixation: The bones are then held together with screws, plates, or other fixation devices to keep them stable during the healing process.
6. Closure: The incision is closed with sutures or staples, and a dressing is applied.

Duration

The procedure typically takes 1 to 3 hours, depending on the extent of the fusion required.

Setting

The procedure is performed in a hospital or surgical center setting under sterile conditions.

Personnel

• Orthopedic surgeon or podiatrist specializing in foot and ankle surgery
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Nerve damage
• Blood clots
• Nonunion (bones not fusing successfully)
• Loss of foot arch or other structural issues
• Pain or swelling post-surgery

Benefits

• Pain relief in the affected joints
• Improved stability and function of the foot
• Correction of deformities
• Increased ability to walk and perform daily activities

Recovery

• Immobilization in a cast or boot for several weeks
• Non-weight-bearing on the affected foot for a specific period
• Gradual return to weight-bearing activities as guided by a healthcare provider
• Physical therapy to restore strength and mobility
• Follow-up appointments to monitor healing progress

Alternatives

• Conservative treatments such as orthotics, pain management, and physical therapy
• Joint injection therapy
• Partial joint replacement or other less invasive surgeries
• Comparing the pros and cons of alternatives typically involves evaluating the extent of symptom relief and potential for recurrence.

Patient Experience

• During the procedure: The patient will be under anesthesia and will not feel pain.
• After the procedure: Pain and swelling are common; pain management will involve prescribed medications. Discomfort is managed with elevation, icing, and following post-operative care instructions.
• Recovery includes a period of non-weight-bearing and gradual rehabilitation to ensure proper healing and restore function.