Often, this extra bone can be obtained from the bone that is cut out to prepare the fusion. Sometimes, there is insufficient bone from this and bone has to be taken from the tibia bone just below the knee. Occasionally, if a large amount of bone is required, it must be taken from the pelvis just above the hip or received from a bone bank.
For those with a tight Achilles tendon (“heel cord”) or weak muscles or both, the Achilles tendon may be lengthened during surgery by making small incisions in the calf and stretching the tendon. Some people with deformities of the foot also have deformed toes. These may be corrected at the same time or more often at a later operation.