What is subtalar fusion?

Subtalar fusion is a surgical procedure that aims to fuse the bones in the subtalar joint, which is located between the heel bone (calcaneus) and the talus bone in the foot. This joint plays a critical role in allowing side-to-side movement and contributes to overall foot mobility and balance. However, certain conditions, such as arthritis, deformities, or injury, can cause significant pain and instability in the subtalar joint. Subtalar fusion permanently stiffens this joint to relieve pain, correct deformities, and restore proper foot alignment and function.

Subtalar fusion indications

Subtalar fusion is indicated for patients who suffer from:

• Post-traumatic arthritis: Damage to the subtalar joint following an injury, such as a fracture, can lead to arthritis and chronic pain.
• Osteoarthritis: Degenerative changes in the joint due to wear and tear can result in pain and dysfunction.
• Rheumatoid arthritis: Inflammatory arthritis conditions can cause joint damage, leading to severe pain and deformities.
• Severe flatfoot deformity: When conservative treatments fail to correct the deformity, subtalar fusion may be necessary to stabilize the foot.
• Chronic subtalar instability: For patients with recurring instability or a collapsed arch that causes pain and difficulty walking, fusion can provide permanent relief.
• Tarsal coalition: A congenital condition where bones in the foot are abnormally connected, causing limited movement and pain.

How does Dr Abramson perform subtalar fusion?

Dr Michael Abramson performs subtalar fusion with a patient-focused and meticulous approach. The surgery begins with the administration of general or regional anaesthesia, ensuring the patient’s comfort throughout the procedure. He makes a small incision on the outer side of the foot to access the subtalar joint. Once the joint is exposed, Dr Abramson carefully removes any damaged cartilage from the surfaces of the talus and calcaneus bones to prepare them for fusion. He then aligns the bones to restore proper foot positioning and uses screws or other fixation devices to securely hold the bones together, promoting fusion.

In cases where bone loss is significant, Dr Abramson may add bone grafts to aid in the fusion process. After ensuring the bones are correctly aligned, the incision is closed with sutures, and a sterile dressing is applied. Post-surgery, patients are typically placed in a cast or boot to immobilize the foot while the bones heal, with Dr Abramson overseeing the recovery process through follow-up care and physical therapy to ensure successful healing and restoration of foot function.

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