Timothy Fitzgibbons, M.D., Orthopaedic surgeon with the Alegent Health Orthopaedic Institute.

Q:  If you suffer from foot drop after surgery, is ankle fusion the answer to keep the foot from turning in more?  What should I look for in a surgeon and a facility?

The question of whether a fusion or a non-fusion procedure is the answer depends on the amount of neurologic involvement.  If the patient has lost complete and total function to the lower extremity and none of the muscles or tendons are functioning, then a fusion is usually the only answer.  However, if only part of the foot and ankle has been affected by the back surgery, then tendon transfers might be an option, which can be done without doing a fusion.

In terms of a facility that would do this procedure:  In my opinion this should be performed by someone or at some place that has subspecialists in foot and ankle problems.  It is probably not something that should be done by a general orthopaedic surgeon.  I would recommend checking to see if the doctor is a member of the American Orthopaedic Foot and Ankle Society, as most of these individuals subspecialize in orthopedic foot and ankle problems, and would have more experience with this type of procedure.  Tendon transfers are not an extremely common procedure, but most foot and ankle subspecialists do a number of these a year.  Fusions are a different story.  Most foot and ankle subspecialists do fusions on a regular basis.