Ankle Fusion surgery
Understanding Ankle Fusions and Physiotherapy Treatment
Ankle fusion, also known as ankle arthrodesis, is a surgical procedure often performed to relieve severe arthritis, correct deformities, or stabilise an unstable ankle. During the procedure, the bones in the ankle joint are fused together using screws, plates, or rods, eliminating the joint entirely. While this surgery can significantly reduce pain and improve stability, it also results in a loss of motion in the ankle. Consequently, the role of a physiotherapist is crucial in the rehabilitation process following an ankle fusion.
Post-Surgical Goals and Physiotherapy Approach
The primary goal after an ankle fusion is to ensure that the patient regains as much function as possible while adapting to the reduced range of motion. A physiotherapist will work closely with the patient to develop a personalised rehabilitation plan that focuses on improving strength, flexibility, and mobility in the surrounding joints, such as the knee and hip, to compensate for the loss of movement in the ankle.
Initial Rehabilitation Phase
In the initial phase following surgery, the focus is on pain management and reducing swelling. Physiotherapists may use modalities like ice, elevation, and compression to control these symptoms. Gentle range-of-motion exercises for the toes and knee, along with isometric exercises (where the muscle is tensed without moving the joint), are introduced early on to prevent stiffness and muscle atrophy.
Weight-Bearing and Gait Training
As the ankle begins to heal, usually around 6 to 8 weeks post-surgery, the physiotherapist will guide the patient in gradually increasing weight-bearing activities. Initially, this might involve partial weight-bearing with the aid of crutches or a walker, progressing to full weight-bearing as tolerated. Gait training is an essential part of this process, as walking patterns need to be adjusted to accommodate the fused ankle. The physiotherapist will help the patient develop a more efficient gait pattern, often involving adjustments in stride length and foot placement to minimise discomfort and maximise function.
Strengthening and Conditioning
Strengthening exercises are introduced to enhance the stability and support provided by the surrounding muscles. This includes exercises targeting the calf, quadriceps, hamstrings, and gluteal muscles. Additionally, the physiotherapist may incorporate balance and proprioception exercises to improve the patient’s ability to maintain stability on uneven surfaces.
Long-Term Management
Even after the initial rehabilitation period, ongoing physiotherapy may be necessary to maintain strength, flexibility, and mobility in the other joints. Patients are encouraged to engage in low-impact activities, such as swimming or cycling, which can help maintain cardiovascular fitness without placing undue stress on the fused ankle.
In conclusion, while ankle fusion surgery can be life-changing, the expertise of a physiotherapist is invaluable in helping patients navigate the post-surgical journey, ensuring they regain as much function and quality of life as possible.
