Introduction:

Triple arthrodesis is a surgical procedure used to fuse three joints in the foot: the talocalcaneal joint, the subtalar joint, and the calcaneocuboid joint. It is commonly performed to treat severe foot deformities and conditions, such as painful arthritis, severe flatfoot deformity (pes planus), and posterior tibial tendon dysfunction (PTTD) that have not responded well to conservative treatments.

Indications:

Triple arthrodesis is indicated for various foot conditions, including:

• Severe arthritis in the hindfoot joints causing pain and disability.
• Irreversible flatfoot deformity that impairs normal foot function.
• Advanced PTTD leading to progressive deformity and pain.
• Failed conservative treatments, such as orthotics and physical therapy.

Procedure:

The surgical procedure involves fusing the talocalcaneal, subtalar, and calcaneocuboid joints to create a rigid structure, eliminating the motion and providing stability to the foot. During the surgery:

• Incisions are made on the foot to expose the affected joints.
• The damaged cartilage is removed from the joint surfaces.
• Bone grafts or bone substitutes are inserted to promote fusion between the bones.
• The bones are fixed with screws, plates, or other fixation devices to hold them in place during the healing process.

Recovery and Rehabilitation:

After the surgery, patients are typically required to wear a cast or a boot to immobilize the foot during the initial healing period. Weight-bearing is restricted, and physical therapy is initiated to improve strength, flexibility, and gait training. The total recovery period can take several months, during which patients may gradually return to normal activities.

Complications:

As with any surgical procedure, triple arthrodesis carries certain risks and complications, including infection, delayed or non-union (failure of bones to fuse), nerve injury, blood vessel damage, and hardware-related problems. The surgeon will discuss these risks with the patient before the procedure.

Outcomes:

The success of triple arthrodesis depends on the patient's overall health, the extent of deformity, and the surgeon's expertise. While the procedure effectively relieves pain and corrects deformity, it may result in some loss of motion in the foot. However, most patients experience significant improvement in foot function and pain relief, allowing them to resume normal daily activities with better stability.

Conclusion:

Triple arthrodesis is a surgical procedure used to fuse three joints in the foot to correct severe foot deformities and provide stability. It is indicated for conditions like arthritis, flatfoot deformity, and posterior tibial tendon dysfunction that have not responded to conservative treatments. While the procedure carries certain risks, it offers significant pain relief and improved foot function for patients with debilitating foot conditions.

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