Midfoot Fusion

Procedure

A midfoot fusion is performed to treat midfoot arthritis or chronic midfoot instability and pain. The procedure usually involves fusion or one or more of the first three tarsometatarsal (TMT) joints (Figure 1). The second TMT joint is most commonly involved, but the first and third may also be affected by pain. Typically the 4th and 5th TMT joints are not fused, as these joints have more motion than the 1st, 2nd, or 3rd TMT joints.

Fusing the joints involves removing any remaining cartilage or other soft tissue debris to create a bony surface that can heal, and then stabilizing the joints with screws, staples, or a plate.  Any prominent midfoot bone spurs (Tarsal Boss) would be removed at the time of surgery. Patients are instructed to remain non-weight-bearing or to limit their weight bearing for 6-8 weeks, until the joints have begun to fuse. Exercises after a midfoot fusions needs to be done in order to strengthen the surrounding muscles and mobilize the local soft-tissues. A midfoot fusion essentially turns a painful, stiff, arthritic joint into a painless, fused joint.

Potential Complications

Complications including non-union, delayed union, nerve injury, and painful hardware can occur.

Previously edited by John Early, MD 

Edited September 29th, 2024

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