Subtalar Fusion ( Arthrodesis)

Hello. I was in an accident in a race car with my son at the end of 2017. I suffered a broken left foot and left ankle, 2 ribs, and a broken neck at C2. neck fusion came first in April of 2018. my left foot and ankle had continued giving me serious issues. I was 50 at the time of the accident and had never broken a bone in my body so all this pain was new to me. getting up and walking after sleeping was like I was 95 years old for the 1st few min or after sitting for as little as 30 min. so I went and got x-rays and later an mri. there was a dime size chunk of bone the broke off and was sitting between 2 tendons so that was nice.... but even worse was at my subtalar I was completely bone on bone. they said within 5 years it will become absolutely debilitating. there was a younger podiatrist in the office doing almost nothing but subtalar fusions and so made the appointment. so it sort of had to be done. surgery was right around Feb 2019. they gave me the cortizone shot to hold me over until the surgery. my scar I believe is on the opposite side since she had to remove the broken bone piece as well. I had the nerve block done before surgery so first few days after wasn't bad. recovery though is just awful. absolutely no weight and for me it was 8 weeks because after xray she wanted 1 more week. I have wood floors in my house and had a few Wipeouts on the knee scooter so that was fun. crutches for another 8 weeks with the boot and slowly increasing weight bearing. after the boot removal and crutches were done there was still lots of swelling and stiffness. I mean there are 2 huge screws going in at your heel through the subtalar. for many many months there was lots of pain and stiffness and swelling when on my feet for a while. she also said my gait wouldn't change just the uncomfortable feeling when on soft or uneven ground like sand. .... um trust me that's a lie. just stepping on the end of where the area rug meets the wood floor was like a sharp pain every time. more than anything.... my gait has definitely changed. that roll like my right foot where the heel strikes 1st and then slightly the outside edge of my foot and then the foot just naturally rolls in.... thats gone on the left foot. there is essentially zero movement side to side and zero rotation in the foot so my left foot just lands perfectly straight and flat. not really noticeable unless I look for it. also, during all that my right calf is much bigger than my left. so a lot of that happened from the 4 months of the scooter and crutches and times you will be hopping around on one foot.... standing in the shower on one leg.... and I think some is just from this new gait. with zero flex side to side its like a lot of the muscles from the normal roll transition my right foot gets... those muscles are no longer getting activated. it's like screwing your foot down to a block of wood... once the bone is fused there is no more movement and for me it still heel strike put a perfectly flat straight transition through to the toes. tilting the foot fore and aft is about the same as my normal foot... just the left and right and tilt inside outside are just solid.

would I do it again.... absolutely. there is no more inflammation or arthritis pain now that the joint is closed. I have some balance issues.... stand on 1 foot and without thinking you are activating that subtalar joint subtlety transferring weight in different directions. when its locked up and fused and you stand on that leg no longer can you just roll your ankle around transferring weight to keep the balance.... you have to use your body arms and such and it feels very uncomfortable if you try to roll that joint around because instead of your foot being flat you're more using your knee area and putting your new Frankenstein foot on its edges instead of rolling the joint around. at least that's my experience and way of trying to simply explain it. lol.... but anyone having issues and lots of pain from arthritis and if the subtalar fusion is the proposed solution... I say some balance loss and discomfort is much better than the alternative. also recovery varies widely... when I was in PT they said I was leaps and bounds ahead of another patient who was 10 months post op and still completely swollen and unable to do much. i did a lot of hobbling around for a long time it seemed and I'd say at 2 years I'm feeling pretty good. lots of swelling up even at the 1 year mark after some long time on feet and discomfort on uneven surfaces was much more apparent at a year then at the 2 year.... so even though you are fused.... I believe it's still a long long road. this was so much worse of a recovery than the broken neck and fused c2/c3 I will say that. hope this helps and I'm sure everyone's experience is unique but this was mine.

Hi Sara,

I am 27 years old and have had subtalar fusions in both feet. I would love to share my journey with you and would have loved a community like this when i had my surgeries. I was diagnosed with the tarsal coalition when i was a few years old. The doctor and my parents decided not to do anything because it did not cause me any pain and it didnt make sense to break a childs feet. However, they did tell my parents that my feet would start bothering me once i was older and full weight bearing... they were correct.

I grew up as a dancer from age 4 through my young adult life. Dancing almost every day, competing, teaching, etc. It was my life. It wasnt until high school that my feet started having pain. The pain was primarily any time I was on my feet consecutively for more than a half hour. The pain was excrutiating and my feet would "lock up" from the swelling in the hind foot. I also was bone on bone with no cartilage in between to prevent rubbing.

When i started exploring the option of surgery, I first saw a surgeon that wanted to do the fusion. The surgery and recovery sounded so extensive that we looked for a second opinion. We found a surgeon who suggested a "resection" where they take cartilage and fill the space between the bones to provide cushion. Unfortuantley, after about 6 months of being back to weight bearing i was back to bone on bone. It was a waste of a surgery.

After some time i started the process again and decided to do the fusions. I will be honest...the surgeries and recovery process are not fun. It will feel like you made things so much worse and wont be able to see yourself walking again. But im here to tell you that the pain and life change of being non weight bearing for 12 weeks is temporary and will EVENTUALLY be a distant memory.

On a day to day basis I do not experience the same pain that i used to. I can walk for a significant amount of time without having pain during and for several days after. I have recently tried to start dancing again and i do not think my feet like the impact of jumping/twisting side to side. It is frustrating but i dont think it makes me question my decision to have the surgeries.

If you choose to go through with the surgeries, here are some of my top recomendations to get you through...

1. Get a leg elevation pillow...it is a million times better than trying to stack pillows.

2. Get a shower bench but wait to use it until after the two week bed rest once you start to get stronger.

3. If you can, treat yourself to a hair blowout every two weeks. I would get so frustrated trying to wash my hair in the bathtub.

4. Rent a knee scooter.

5. Buy pads for your crutches.

6. Once you get to the walking boot stage you might look into a shoe leveler. I had a lot of lower back pain from the uneven-ness of the walking boot.

I hope this helps and i would be happy to answer any questions you have. Hang in there!

All the best,

Kelsey

Hi I was wondering if you got it done? what was your experience?

HOLY CRAP!!! That is such a long recuperation!!