Knöchelfusion (Ankle Arthrodesis)

Ankle fusion joins the shin bone (tibia) to the talus beneath it so that they heal into one solid bone. The worn, painful joint surfaces are removed and the bones are held together with screws, a plate or a nail until they unite.

It reliably removes the pain of severe ankle arthritis and gives a stable, durable foot for walking. The up-and-down ankle movement is lost for good, and the extra load shifts to the neighbouring foot joints, which can develop arthritis over the following 10 to 20 years.

What Ankle Fusion (Ankle Arthrodesis) involves

Remaining cartilage and the hard bone beneath it are removed from both surfaces until healthy bleeding bone is exposed, either through two keyhole portals with a burr (arthroscopic fusion) or through an open incision at the front or side. Any deformity is corrected and the foot is set in the functional position: at a right angle to the leg, heel tilted slightly outward and the foot turned out a little, to match the other side. Two or three large compression screws are passed across the joint under X-ray, or a front plate or a nail inserted through the heel is used when bone is poor or the joint below is also being fused. Bone graft from the heel, shin or pelvis fills any gaps.

Who is a good candidate for Ankle Fusion (Ankle Arthrodesis)?

Considered when ankle pain limits daily life and bracing, injections, footwear changes and painkillers no longer help.

• End-stage post-traumatic, osteoarthritic or inflammatory ankle arthritis
• Younger, heavier or physically hard-working patients, for whom an implant would wear out
• Severe deformity, instability or paralysis around the ankle
• Failed ankle replacement or avascular necrosis of the talus
• Charcot or neuropathic joints, with suitable fixation

Es ist normalerweise nicht die richtige Wahl, wenn:

• Active infection in the ankle, which is treated first
• Smokers who will not stop: nicotine multiplies the risk of the bones failing to unite
• Severe arterial disease with poor skin blood supply
• Significant arthritis already present in the subtalar and midfoot joints, where replacement may protect them better
• Milder arthritis that could be managed with debridement, realignment osteotomy or distraction

Technikoptionen

• Arthroscopic ankle fusion: Keyhole preparation and screws through small cuts. Less wound trouble and quicker union; for ankles with little deformity.
• Open fusion with screws or plate: Allows correction of marked deformity and bone grafting.
• Tibiotalocalcaneal (hindfoot) nail: Fuses the ankle and the subtalar joint below it together, for combined arthritis, poor bone or salvage.
• External ring fixator: Used when infection or poor skin rules out internal metalwork.
• Total ankle replacement: The motion-preserving alternative for older, lower-demand patients with good alignment.

Was passiert während Ihrer Behandlung

Surgery takes 1.5 to 2.5 hours under spinal or general anaesthesia, usually with a nerve block behind the knee that keeps the foot numb for 12 to 24 hours. You wake in a plaster backslab with the leg elevated and stay 1 to 3 nights.

Vorbereitung auf Ihre Reise

Planen Sie 10 bis 14 Tage in Istanbul. Ihr Chirurg überprüft Fotos und Ihre Krankengeschichte, bevor Sie buchen, und Sie treffen sich persönlich am Tag vor der Operation zur Untersuchung, Markierung und Zustimmung mit einem professionellen Dolmetscher.

• Stoppen Sie das Rauchen und Nikotin mindestens vier Wochen vor und nach der Operation; es ist die größte vermeidbare Ursache von Wundproblemen
• Erzählen Sie dem Team von allen Medikamenten und Ergänzungen, die Sie einnehmen; Blutverdünner, einige Kräuterprodukte und Hormonbehandlungen müssen möglicherweise auf Anraten Ihres Arztes unterbrochen werden
• Vereinbaren Sie, dass jemand mit Ihnen reist oder erreichbar ist, und halten Sie die ersten Tage zu Hause frei von Arbeit und Heben
• Buchen Sie einen veränderlichen Rückflug; Ihr Chirurg bestätigt, wenn Sie fit sind

Genesung und Ergebnisse

You must keep weight off the foot for about 6 weeks, using crutches, a frame or a knee scooter, then walk in a boot with increasing weight for another 6 weeks if X-rays show healing. Solid union usually takes 3 to 4 months, confirmed by X-ray or CT. Swelling lasts 6 to 12 months. A rocker-soled shoe smooths walking. Most people walk without a visible limp on level ground; running, steep slopes and uneven terrain are harder.

• Back to everyday activity: 3 to 4 months to full weight-bearing
• When results show: Pain relief is clear once fused, at 3 to 6 months
• Wie lange sie dauern: Dauerhaft

Sicherheit, Risiken und Revisionspolitik

The main concern is whether the bones unite; the patient's own habits and health strongly affect this.

• Non-union (failure to fuse) in about 5 to 10 percent, much higher in smokers and diabetics, often needing revision
• Fusion in a less than ideal position, causing pain or a vaulting gait
• Wound healing problems and infection
• Nerve injury with numbness or a tender neuroma over the foot
• Prominent or painful screws requiring later removal
• Blood clots in the leg during the non-weight-bearing period
• Arthritis in adjacent foot joints in later years
• Stress fracture of the tibia above the fusion, rare

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Ankle Fusion (Ankle Arthrodesis) in Türkiye

Clinic-Y does not publish a single price for Ankle Fusion (Ankle Arthrodesis), because the honest figure depends on your case. What moves it:

• Arthroscopic versus open surgery
• Fixation: screws, plate or hindfoot nail
• Bone graft or bone graft substitutes
• Hospital nights, boot, and follow-up imaging including CT to confirm union

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