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Foot + Ankle Problems + Treatments

Midfoot Arthitis

Type of Procedure: Outpatient surgery
Length of Procedure: 1 hour
Anesthesia: General anesthesia with a Nerve Block

What is Tarsometatarsal Arthrodesis?

This surgery fuses or glues together (arthrodesis) some of the small joints in the middle of the foot. Because this area of the foot has very little motion normally, the fusion of these joints typically does not cause significant sensation of stiffness or decrease in function.

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A staple with or without a small plate is inserted into the bones to hold the joints together while the fusion occurs. Rarely, a small amounts of allograft (cadaver) bone graft is used to stimulate the bone healing. Once the joint is fused the hardware is not necessary, but is rarely removed.

General Recovery Facts

  • You will not be walking on the leg for about 6 8 weeks
  • In order to stay off your foot, you will need to use crutches, a walker, a wheelchair or a scooter type device called a roll about.
  • There will be a hard plaster bandage applied to the leg for two weeks after surgery
  • Your first follow up visit will be at approximately 2 weeks to remove the stitches
  • We will usually apply a removable boot for you to wear at two weeks, but occasionally we use a short leg below the knee cast.
  • If the surgery is on your left foot, you should be able to drive an automatic vehicle at two weeks. If the surgery is on the right foot, you may drive between 3 and 4 weeks.
  • Physical therapy for 1 to 2 months is helpful to regain strength and movement
  • There will be moderate swelling of the foot, ankle and leg for at least 6 months

Specific Postoperative Course for Tarsometatarsal Arthrodesis

Day 1

  • Foot wrapped in bulky bandage and splint
  • Ice, elevate, take pain medication
  • Expect numbness in foot 12 24 hours, then pain
  • Blood drainage through bandage expected
  • Do not change bandage

Day 14

  • First follow up in the office
  • Dressing changed
  • Placed in cast or boot.
  • No weight bearing for minimum of 6 weeks

6 weeks

  • Cast/boot removed
  • X-rays taken
  • Use the boot for about 4 more weeks
  • Full weight bearing is allowed
  • The boot can be removed at night, and for gentle movement exercises
  • Swimming is permitted, but with limited pressure on the foot

12 weeks

  • X-rays taken
  • Start Exercise program and physical therapy
  • An orthotic arch support may be ordered
  • A stiff soled shoe is encouraged for two more months