Foot or toe joint fusion: 3 things to know

Joint fusion stabilizes painful joints and aligns bones to reduce discomfort and increase stability for patients.

Joint fusion is an option if you have pain in your foot or toes that won’t go away through other treatments and corrective measures.

A joint fusion is a procedure where separate bones are combined or fused together to eliminate the joint. This is can be performed in the forefoot with most common areas including the big toe joint, mid-foot, rear foot or ankle joint.

Joint fusion decreases pain and improves function

While joint fusion can help eliminate various foot problems, it’s mainly done to decrease arthritic pain. This pain could be due to previous trauma such as occurs with traumatic arthritis or in overuse wear and tear type arthritis. Systemic causes such as rheumatoid arthritis also can lead to painful arthritic joints.

Joint fusion eliminates the motion at the painful arthritic joint and restores the bones to their proper position. Fusions also can help improve other conditions such as flat feet. “The goals of surgery are to help reduce discomfort and increase the stability,” said Dr. Gregory Poole, Marshfield Clinic Health System podiatrist. “This thereby improves the patient’s ability to weight-bear and increase their overall function.”

Patients go home same-day after surgery

In this outpatient surgery, the surgeon removes the remaining damaged cartilage surfaces from both sides of the joint and places the bones in the proper position. Then screws and or plates are utilized to bring and hold the bones together allowing them to fuse over time in the corrected position. A well-padded splint keeps the area immobilized and helps control swelling during initial recovery.

Recovery requires a period of non-weight bearing and immobilization of the surgical foot generally for 6 to 12 weeks depending on the site of the fusion. Patients can use crutches, knee walker or a wheelchair and will transition to a cast or brace as the fusion heals. With post-operative follow-ups, the surgeon will advise when the patient can gradually begin weight bearing activities and physical therapy.

As with all surgeries there are possible complications including the risks associated with anesthesia, infection, painful scar, nonunion, nerve damage, painful internal fixation and blood clots. Not all patients are good surgical candidates for a joint fusion. Health concerns such as osteoporosis, active infection, poor blood flow to the feet and neurological conditions can interfere with healing and recovery.

Pain relief when all other treatment options have failed

Before suggesting joint fusion, your provider will work with you to find alternative options to improve your joint pain and help you maintain your daily activities and lifestyle. “One of the most beneficial conservative modalities for treatment of painful arthritic joints in the foot is a functional orthotic, ” Dr. Poole said. “An orthotic is custom insert made specifically for the patient to be utilized in their shoes to help control the mechanics of the feet and stabilize the joint.”

Orthotics minimize the motion at the arthritic painful joint and help reduce inflammation and discomfort. Orthotic management can help to prolong the need for joint fusion surgery. It also can help reduce pain for those patients who are unable to proceed with elective surgery.

Do you have painful foot or toe joints? Talk to your doctor about a referral to a podiatrist to learn about available treatment options.