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The main nerve of your foot controls the muscles in your sole and gives feeling here and to your toes. Other nerves give feeling to the top and outside edge of your foot.
The muscles in your lower leg are attached to bones in your feet by tendons, and they control movement that allows us to stand, walk, go on tiptoes and jump. These muscles move your toes and control the position of your foot as it hits the ground, allowing it to become flexible and cushioning the impact. They also make the arches of your feet more rigid to push your body forward when you move.
Your heel bone is connected to the calf muscles in your lower leg by your Achilles tendon, which is the most important tendon for movement. The tibialis posterior tendon, which attaches the underside of your foot to your lower leg, helps supports the arch of your foot and allows you to turn it inward.
Ankle fusion involves removing the damaged ankle joint and fusing your talus bone to your tibia to form a stiff but pain-free ankle. Your foot is fused at a right angle to your leg, in the position it would be if you were standing up. Your bones are held together using screws and new bone grows across, creating one bone where there were two. It normally takes between 12–14 weeks for the fusion to be complete and your bone continues to become stronger after this.
In some cases this procedure can be performed using keyhole surgery (arthroscopy), which means it can be done through just a small cut, so your joint doesn’t have to be opened up. The procedure takes between one and two hours.
After surgery you’ll need to wear a cast for 6–12 weeks, depending on your situation. You should be able to wear normal shoes after the cast is removed, although some alterations are occasionally needed. It should be easier to walk normally or even more comfortably than you did before surgery if your other joints aren’t affected by arthritis, but running isn’t recommended.