Tips, Quips, and Pearls| Volume 49, ISSUE 3, P305-309, May 2010

Technique Tip: Subtalar Joint Fusion Using a Parallel Guide and Double Screw Fixation

Published:April 01, 2010DOI:


      A wide range of techniques has been described to achieve subtalar (talocalcaneal) arthrodesis using interfragmental screw fixation. In this technical report, we describe a method that enables us to accurately position 2 screws across the subtalar joint in order to achieve arthrodesis between the talus and calcaneus. Careful attention to the tips described in this report should minimize the risk of aberrant placement of the screws while expediting the process of osteosynthesis.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Diezi C.
        • Favre P.
        • Vienne P.
        Primary isolated subtalar arthrodesis: outcome after 2 to 5 years follow up.
        Foot Ankle Int. 2008; 29: 1195-1202
        • Haskell A.
        • Pfeiff C.
        • Mann R.
        Subtalar joint arthrodesis using a single lag screw.
        Foot Ankle Int. 2004; 25: 774-777
        • Wilson P.
        Treatment of the fractures of os calcis by arthrodesing of the subtalar joint: a report of 26 cases.
        JAMA. 1927; 89: 1676-1683
        • McGlamry M.C.
        • Robitaille M.F.
        Analysis of screw pullout strength: a function of screw orientation in subtalar joint arthrodesis.
        J Foot Ankle Surg. 2004; 43: 277-284
        • Gable S.J.
        • Bohay D.R.
        • Manoli 2nd, A.
        Aiming guide for accurate placement of subtalar joint screws.
        Foot Ankle Int. 1995; 16: 238-239
        • Bori G.
        • Soriano A.
        • Garcia S.
        • Mallofre C.
        • Riba J.
        • Mensa J.
        Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection.
        J Bone Joint Surg Am. 2007; 89-A: 1232-1237
        • Dennyson W.G.
        • Fulford G.E.
        Subtalar arthrodesis by cancellous grafts and metallic internal fixation.
        J Bone Joint Surg Br. 1976; 58-B: 507-510
        • Easley M.E.
        • Trnka H.J.
        • Schon L.C.
        • Myerson M.S.
        Isolated subtalar arthrodesis.
        J Bone Joint Surg Am. 2000; 82-A: 613-624
        • Gosch C.
        • Verrette R.
        • Lindsey D.P.
        • Beaupre G.S.
        • Lehnert B.
        Comparison of initial compression force across the subtalar joint by two different screw fixation techniques.
        J Foot Ankle Surg. 2006; 45: 168-173
        • Mann R.A.
        • Beaman D.N.
        • Horton G.A.
        Isolated subtalar arthrodesis.
        Foot Ankle Int. 1998; 19: 511-519
        • Thomas F.B.
        Arthrodesis of the subtalar joint.
        J Bone Joint Surg Br. 1967; 49-B: 93-97
        • Finlay J.B.
        • Harada I.
        • Bourne R.B.
        • Rorabeck C.H.
        • Hardie R.
        • Scott M.A.
        Analysis of the pull-out strength of screws and pegs used to secure tibial components following total knee arthroplasty.
        Clin Orthop Relat Res. 1989; 247: 220-231
        • Chapman J.R.
        • Harrington R.M.
        • Lee K.M.
        • Anderson P.A.
        • Tencer A.F.
        • Kowalski D.
        Factors affecting the pullout strength of cancellous bone screws.
        J Biomech Eng. 1996; 118: 391-398
        • Chuckpaiwong B.
        • Easley M.E.
        • Glisson R.R.
        Screw placement in subtalar arthrodesis: a biomechanical study.
        Foot Ankle Int. 2009; 30: 133-141