Ankle & hindfoot
Subtalar and hindfoot fusion
Painful hindfoot arthritis or deformity: choosing which joints to fuse and what that means for movement.
Understanding the condition
The subtalar joint lies below the ankle and contributes to adapting the foot to uneven ground. Arthritis may follow a heel fracture or other disease. A triple fusion treats three hindfoot joints. Assessment identifies the painful joints and whether deformity is flexible or fixed.
Treatment options
Supportive shoes, insoles, braces, activity changes and suitable pain relief may help. A targeted injection can help clarify the source of pain. Continuing non-surgical care, isolated fusion or a different combination of joints may be reasonable alternatives.
What a procedure may involve
The selected joint surfaces are prepared and fixed in a corrected position with screws or other metalwork. Bone graft may be needed. Fusing the ankle as well as the hindfoot is a more extensive operation and requires a separate discussion of its effects.
Risks and benefits to discuss
Fusion aims to reduce pain and improve stability. It permanently reduces motion in the treated joints, particularly side-to-side movement. Risks include nonunion, malalignment, wound or nerve problems, infection, painful metalwork, blood clots, persistent pain and revision surgery. Bone graft harvest has additional risks.
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
Expect a period of protected mobility. Keep wounds and the cast dry, elevate the foot and attend reviews. Your weight-bearing schedule depends on the joints fused, fixation and healing. Exercises focus on safe movement of unfused joints and later gait, strength and balance.
Expected outcomes and recovery
Improvement takes months and swelling can remain for a prolonged period. Level-ground walking may improve with pain relief, while uneven ground and high-demand activities can remain challenging. A fusion cannot restore joint motion.
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.
Private care in Huddersfield
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