Ankle & hindfoot
Ankle fusion
A guide to ankle arthrodesis, including pain relief, permanent stiffness and protection while the bones heal.
Understanding the condition
Ankle fusion may be offered for severe painful ankle arthritis or deformity. It joins the tibia and talus so that the ankle joint no longer moves. Other foot joints still move. The decision depends on symptoms and function, rather than an X-ray alone.
Treatment options
Alternatives include bracing, footwear changes, walking aids, physiotherapy, medication and selected injections. Ankle replacement may be suitable for some people. The advantages and limitations of each option should be discussed before deciding.
What a procedure may involve
The damaged joint surfaces are prepared, the ankle is positioned and fixation holds the bones while they grow together. Surgery may be open or keyhole. Screws, plates or a nail and bone graft are chosen for the particular problem. A nail crossing the ankle and subtalar joint is a different, more extensive fusion.
Risks and benefits to discuss
The goal is less pain and a stable foot for walking. Risks include nonunion, delayed union, an unsatisfactory position, painful metalwork, infection, skin or nerve problems, blood clots, persistent pain and further surgery. Adjacent joints may become painful or arthritic over time. Smoking and nicotine use impair bone healing.
Any operation also carries bleeding and anaesthetic risks. Occasionally, complex regional pain syndrome causes prolonged pain and sensitivity. Your health and the extent of surgery change your personal risk.
Rehabilitation and aftercare
Keep dressings and the cast dry, elevate the limb and use walking aids as taught. Do not try to regain movement at the fused joint. Progression to weight bearing, footwear and strengthening depends on fixation, wound healing and imaging; use the schedule supplied for your own operation.
Expected outcomes and recovery
Bone healing and functional improvement take months. Swelling can last much longer than early wound healing. Walking often improves when pain reduces, but the ankle remains permanently stiff and uneven ground or demanding sport may be more difficult.
When to seek urgent help
Seek prompt advice for rapidly increasing pain, spreading redness, wound discharge, fever, new numbness or a cast or boot causing pressure. New calf pain or swelling needs urgent assessment. Chest pain or breathlessness needs emergency help: call 999.
Your consent discussion
Ask which treatment best addresses your symptoms, what alternatives are reasonable, what the main risks mean for you, and what recovery will involve at home and work. This guide supports that discussion; consent is completed with your treating team. Your individual written instructions take priority.
Your consent discussion
Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.
Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.
Further reading & sources
Prepared 10 October 2026 for the practice of Mr Peyman Bakhshayesh. Professional background. General patient education; your clinical assessment and written instructions determine your care.
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