Corticosteroid Injections for Osteoarthritis, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Smoking Pot Every Day Linked to Heart Risks, Artificial Sweetener Linked to Heart Risks, FDA Authorizes First At-Home Test for COVID and Flu, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox. Simultaneous calcaneocuboid and talonavicular fusion. Lengthening the lateral column of the foot has been shown to correct flatfoot deformity. Anesthesia with Calcaneocuboid Joint Arthrodesis: Calcaneocuboid joint arthrodesis is typically performed under local anesthesia and sedation. Thank you for taking a look at our site. The incision is carried anteriorly and curved toward the plantar aspect of the first . It is commonly performed to help correct the condition of pes planus (commonly called flat foot or fallen arch). 2019 Jan 8;11(1):e3847. Fractures of the cuboid are best approached through the dorsolateral approach to the cuboid. This site needs JavaScript to work properly. Bookshelf A replacement retains movement of the joint after surgery, unlike a fusion. A gastrocnemius releasemay need to be performed in cases with postoperative gastrocnemius contracture. 2014 Sep;117(9):785-90. doi: 10.1007/s00113-014-2603-6. Those with subtalar problems typically complain of pain along the outer side of the foot just below the ankle. Healing can take up to 12 weeks, so youll want some help getting through your daily life. 520 East 70th Street Starr Pavilion, 2nd Floor, New York, NY 10021 4.46 miles Accessibility Biomechanical principles are used to illustrate orthotic management of diseases that affect the transverse tarsal joint. A failed fusion can ultimately result in amputation. Accessibility This allows them to rest comfortably throughout the procedure without feeling any pain. It is a synovial articulation between the calcaneus and the cuboid bones of the foot. 2010 Jul-Aug;49(4):380-4. doi: 10.1053/j.jfas.2010.04.023. Still, you could experience: Smokers are also at risk for a condition doctors call pseudoarthrosis. Use a lateral-column distractor to achieve the articular surface visualization needed for accurate reduction and fixation. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Momberger N, Morgan JM, Bachus KN, West JR. Zhou H, Ren H, Li C, Xia J, Yu G, Yang Y. Biomed Res Int. Calcaneocuboid joint. Percutaneous subtalar joint screw fixation of comminuted calcaneal fractures: a salvage procedure. The site is secure. You wont be able to move it anymore. The fracture is distracted to allow complete visualization of either joint surface as needed. Foot Ankle Int. The AlloAid DBM is terminally sterilized using a validated gamma irradiation process at an SAL (Sterility Assurance Level) of 10-6. Calcaneocuboid fusion: The hindfoot consists of four bones and three joints. Bookshelf 2005 - 2023 WebMD LLC. 5. 2000 Sep;21(9):730-5. doi: 10.1177/107110070002100903. It is continuous with the thickening of the dorsal articular capsule of the calcaneocuboid joint and can have a variable appearance due to anatomic variations. My thesis aimed to study dynamic agrivoltaic systems, in my case in arboriculture. PMC 2. Finding top-rated doctors who perform SI Joint Fusion near you is simple on WebMD Care. Careers. JavaScript is disabled. J Am Acad Orthop Surg. 6000 Poplar Ave., Ste. Punwar S, Madhav R. Dislocation of the calcaneocuboid joint presenting as lateral instability of the ankle. SAL 10-6 designates the probability of finding an unsterile product to be 1 in a million. and transmitted securely. After you go home, contact your doctor if you exhibit signs of infection, such as: Redness, tenderness or swelling. The graft is harvested from either the distal or proximal tibia. Anatomic Reconstruction of Malunited Chopart Joint Injuries. After lateral column lengthening with calcaneocuboid fusion, 48% of talonavicular and 70% of subtalar joint range of motion were preserved. In addition, look for the Patient's Perspective boxes and callouts that tell you what other . While seated, the foot should be on a cushion and elevated, but if badly swollen, the patient must be supine since elevating the foot while seated decreases swelling less effectively. The talus, calcaneus, cuboid, and navicular bones are separated by cartilage and create the talocalcaneal, talonavicular, and calcaneocuboid joints. Operative treatment of the difficult stage 2 adult acquired flatfoot deformity. Our surgeons are fellowship-trained and specialize exclusively in caring for lower extremity conditions. Healing can take up to 12 weeks, so youll want some help getting through your daily life. Designates the occurrence of a living microorganism surviving the sterilization process. 2012 May;33(5):386-93. doi: 10.3113/FAI.2012.0386. REQUEST AN APPOINTMENT Subtalar fusion has been shown to surgically work in up to 85-95% of cases. However, everyone is different and your recovery may be different from other people's. If this is your first visit, be sure to check out the. Remove the cartilage from the anterior facet of the calcaneum using a curette. Triple fusion is the joining together of three joints (the talonavicular, subtalar and calcaneocuboid joints) as a treatment for arthritis or as a method of correcting a . The calcaneocuboid joint is stable, although multiple conditions might affect the joint, including arthritis, fracture, subluxation, and dislocation. This will allow your bones to fuse. [2] part of the bifurcated ligament. Early weight-bearing may be tolerated depending on the fracture pattern. Hello, Just thought I would post here as I'm amazed by how well progress has been for me and it might give others positivity if anyone has the same procedure. Bridging may be achieved using either an external fixator or a reconstruction plate until the cuboid has healed. What is it? Potential Complications from Calcaneocuboid Joint Arthrodesis: The potential complications of calcaneocuboid joint arthrodesis include bleeding, infection and a negative reaction to the anesthesia that is used. Tribio Backfill Plugs are a proprietary material delivered sterile and ready for use in any bony voids or gaps of the skeletal system. It is demonstrated that when fusing the calcaneocuboid joint, attention should be paid to maintaining a neutral position of the foot, which resulted in significant decreases in motion in the talocalcaneal and talonavicular joints. ), The ligaments of the foot from the lateral aspect. For a better experience, please enable JavaScript in your browser before proceeding. Over time, arthritis can cause severe damage to your joints. Plantar and calcaneocuboid joint pressures were measured in neutral, inversion, and eversion in the intact foot, with isolated medial column fusion, and with medial and lateral column fusion. Unable to load your collection due to an error, Unable to load your delegates due to an error. Penetrate the subchondral bone using a high-speed burr or drill to promote bone growth. Calcaneocuboid fusion treatment is performed with the patient under the effects of general anesthesia. Minor Ankle Procedures + Standard Protocol These ankle surgeries are considered more minor and have the advantage that most patients can walk much sooner. 1. Lateral column length is critical to maintaining the shape and function of the foot. Unauthorized use of these marks is strictly prohibited. 2012 Jan;29(1):91-102. doi: 10.1016/j.cpm.2011.09.004. If any complication is suspected (eg, infection or compartment syndrome), the dressing must be split and, if necessary, removed to allow full inspection. And, youll need to keep all weight off the joint. hope this helps. [2] the long plantar ligament. The innervation of the joints of the foot. 2012 Jun;17(2):309-22. doi: 10.1016/j.fcl.2012.03.008. You will need to use crutches when walking or climbing stairs as you will not be able to bear weight through the ankle. Most people do well after having it, and complications are rare. Anatomico-radiological Study of the Bifurcate Ligament of the Foot with Clinical Significance. HHS Vulnerability Disclosure, Help (2007) The Journal of bone and joint surgery. It is a synovial articulation between the calcaneus and the cuboid bones of the foot. This could mean youll use crutches, a walker, or a wheelchair to get around. This representation of SAL illustrates the occurrence of a living microorganism surviving the sterilization process. Sterile undercast padding is placed from toes to knee. Plating can be performed through the dorsolateral incision aligned with the fourth metatarsal. Churchill Livingstone. The anterior area is left free of plaster to allow for swelling. As with all foot surgery it is common for minor discomfort and swelling to persist for some months after surgery and is completely normal. This surgical procedure helps to create an arch in the foot. These alternatives include pain medication, strength training, physical therapy, or steroid injections. The goal of the treatment is bone healing with appropriate intra- and extra-articular reduction to maintain lateral column length. Before What is a Talonavicular Fusion? Calcaneocuboid joint arthroplasty and foot fusion are surgical alternatives to the procedure. Background: Isolated subtalar arthrodesis is generally successful, with reported fusion rates of 84% to 100%. Katie, I would look at the code set 28705-28760, not sure which joint but 28740 is midtarsal or tarsometatarsal joint, single. Extra side and posterior cushion padding are added. Please enable it to take advantage of the complete set of features! The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). This means youll stay awake, but the area of the joint will be fully numbed. official website and that any information you provide is encrypted The traditional fixation for a calcaneocuboid (CC) arthrodesis in triple arthrodesis is with a 6.5-mm cancellous screw. FOIA Recovery from Calcaneocuboid Joint Arthrodesis: The total recovery time for calcaneocuboid joint arthrodesis is eight to 12 weeks. Contour the plate to fit the cuboid anatomy. Our goal is for you to experience the following benefits after surgery: Location: The joint will then be rigid and no longer painful. Joint fusion surgery may also not be right for you if you have a health issue, like: Youll go into the hospital or have outpatient surgery (go home the same day), depending on the type of joint fusion surgery you need. Your doctor will help you control this. An incision is made and the damaged cartilage is removed from the joint so that the surface of your bones is level. Once the fusion site is prepared, the distraction can be adjusted to achieve the correct length of the lateral column. Instead of bridge plating, the lateral column distractor can be replaced with an external fixation construct, which can be left in place while the bone heals. 2014 Nov;43(11):1025-39; quiz 40. doi: 10.1007/s00132-014-3037-0. The exposure is via the distal end of the incision used for the subtalar fusion. It is helpful to have comparative x-rays from the uninjured side, allowing proper length and morphology to be judged. Think of the thigh bone and shin bone. A tibial bone graft may be taken from your knee area to be used in conjunction with the screws. The https:// ensures that you are connecting to the Each blister pack contains all the necessary instruments for implanting: 2.0, 2.5, 3.0 and 3.5mm Compression Screws. Foot Ankle Int. MedStar Health is home to a team of doctors who specialize in surgical treatments, such as foot and ankle fusion surgery. The osteoconductive scaffold rapidly absorbs the surrounding blood and fluids to aid in new bone formation during the healing process. It is used to treat a wide range of foot and ankle conditions that cause chronic pain in the foot and ankle joint. doi: 10.7759/cureus.3847. Because we find that our patients are careful during the recovery time, we allow our patients to put full weight on their ankle after their first post-op visit. Normal Anatomy and Traumatic Injury of the Midtarsal (Chopart) Joint Complex: An Imaging Primer. (for 8mm void) by 40mm in length. These findings demonstrate the need for clinical investigation of this procedure, which could preserve motion in the talonavicular and subtalar joints, correct deformity, and obviate calcaneocuboid arthritis. - arthrodesis of 1st metatarsal-tarsal joint and. Calcaneocuboid arthritis is a form of osteoarthritis which affects the calcaneocuboid joint, that is located between the cuboid bone and the heel bone. Calcaneocuboid arthrodesis is more commonly performed as an adjunct procedure with other rearfoot procedures such as triple arthrodesis and is less used as isolated fusion. (2004) Foot & ankle international. The calcaneocuboid joint is the joint between the calcaneus and the cuboid bone. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. This leaflet tells you what to expect as you recover from having foot fusion surgery. Disclaimer. PMC Foot Ankle Clin. Sometimes, your surgeon will place a small piece of bone between the two ends of your joint. Once the swelling goes down and the incisions are healing, your doctor may put on a cast or a removable boot. This article reviews the main conditions of the lateral column and calcaneocuboid joint in particular. This operation removes any degenerate joints and fixes the joints together, with the aim that bone will grow across and fuse the joints. Unauthorized use of these marks is strictly prohibited. The long plantar ligament lies superficial to the short plantar ligament. Your ankle needs to be fully fused before you can drive. In some cases fusion of the bones in your midfoot may ease your pain and aid your mobility. You will remain in the boot for about 12-14 weeks after surgery and will continue to increase your activity at that point. How would I coding these procedures: - arthrodesis of the calcaneocuboid joint with. A mid foot fusion plate from the Arthrex system was then placed appropriately and pinned in position. The talonavicular joint is critical in allowing the foot to move inwards and outwards, as well as in a circular motion. Our experienced orthopedic surgeons offer you the comprehensive care you need for an effective procedure and a successful recovery. However the patient satisfaction resulting from this surgery is a more realistic 80-85%. Change location What are the 7 steps in analytical process? Prognosis after Calcaneocuboid Joint Arthrodesis: The prognosis for a positive end result following calcaneocuboid joint arthrodesis is good. British volume. It covers the incision, the desired outcome, the osteotomy and fixation. Analysis of the inversion and eversion ranges of motion suggests that the lengthening fusion limits eversion more than inversion. Amazing subtalar and calcaneocuboid fusion recovery. Using custom orthotics, walking aids, or foot braces are also alternatives. This occurs more typically in the mid and hind-foot. The plate length should allow for fixation using a minimum of three screws both proximally and distally. official website and that any information you provide is encrypted Supplemental fixation (screw or K-wire) can be placed from the fifth metatarsal (which can be rendered unstable by this injury) through the fourth metatarsal into the third metatarsal, or lateral cuneiform; which will further prevent lateral column shortening. FOIA The calcaneocuboid joint is stabilized by ligaments on its superior and inferior aspects. Sterility The lateral dislocation can be reduced under sedation with flexion in the knee, longitudinal traction on the foot and lateral pressure on the talus. American Academy of Orthopaedic Surgeons: Spinal Fusion Surgery., FootCareMD/American Orthopaedic Foot & Ankle Society: Ankle Arthrodesis, First MTP Joint Fusion, Midfoot Fusion., OrthoArizona/Arizona Bone and Joint Specialists: Joint Fusion Surgery., Chesterfield Royal Hospital/NHS, Patient information: What to Expect After Your DIP Joint Fusion., Mass General Hospital Orthopaedics: Back On Your Feet: A Patient Guide to Foot & Ankle Treatments., Arthritis Foundation: Surgery for Aching Hands.. Rammelt S, Zwipp H, Schneiders W, Heineck J. Eur J Trauma Emerg Surg. [1] Ligaments [ edit] There are five ligaments connecting the calcaneus and the cuboid bone, forming parts of the articular capsule : the dorsal calcaneocuboid ligament. Calcaneocuboid fusion - The hindfoot consists of four bones and three joints. They are fused together with metal plates, pins, or screws. Last's anatomy, regional and applied. 115 Memphis, TN 38119, Available in flowable, formable putty and crunch in syringe, Donor recovery and screening performed according to AATB and FDA guidelines, Crunch consists of DBM putty & cortical cancellous bone chips, Moldable, sterile, demineralized/compressive bone matrix, Cut and molded as needed, sponge-like fit and fill capabilities, Natural porous scaffold encourages osteoconductivity and promotes vascularization and stimulates new bone growth, Add bone marrow aspirate or platelet rich plasma to create a composite graft. registered for member area and forum access. 2000 Oct;21(10):845-8. doi: 10.1177/107110070002101008. The superficial fibers of the long plantar ligament continue to the second to fourth metatarsals, bridging over the groove containing the fibularis longus tendon 1. Plates feature an Oblong Compression Slot option. A calcaneocuboid fusion fuses together the calcaneus and cuboid bones of the hindfoot. Fortin 4 reported that subtalar joint motion was reduced by 80% to 90% after an isolated fusion of the talonavicular joint and that motion of the calcaneocuboid joint was lost completely, leading to accelerated arthrosis of adjacent joints. National Library of Medicine The medial calcaneocuboid ligament is the lateral band of the bifurcate ligament. [vid_icon]Gout: Risk Factors and Triggers, Slideshow: Knee Surgery Recovery Timeline, Slideshow: Ankle Replacement Recovery Timeline, Taking Care of Your Joints After Ankle Replacement, A nervous system (neurological) problem that may keep you from healing. Calcaneocuboid arthrodesis is more. 8600 Rockville Pike You are using an out of date browser. Calcaneocuboid joint pressure after lateral column lengthening in a cadaveric planovalgus deformity model. Bethesda, MD 20894, Web Policies The metalwork usually stays in the foot for the rest of your life. This procedure can also relieve symptoms of back problems like degenerative disk disease and scoliosis. Objectively, four feet were rated excellent, eight good, four fair and none poor. Your doctor may choose to give you general anesthesia, which will allow you to sleep through the procedure. The demonstration is performed by. The joints will then be rigid and no longer painful. Therefore, the cuboid length must be maintained. The procedure is performed with the patient placed supine with the knee flexed 90. Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. Get personalized tips to reduce discomfort. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mosier-LaClair S, Pomeroy G, Manoli A 2nd. 25 (5): 349-56. Calcaneocuboid distraction arthrodesis (CCDA) is regarded as an effective method for reconstructing adult-acquired flatfoot deformity. 2022 Oct;48(5):4043-4051. doi: 10.1007/s00068-022-01923-0. Unfallchirurg. [Joint-preserving correction of Chopart joint malunions]. The brace is usually worn for about a month. The plate is fixed with locking head screws. Beimers L, Louwerens JW, Tuijthof GJ, Jonges R, van Dijk CN, Blankevoort L. Foot Ankle Int. 4. Following surgery, you will need to keep your foot elevated to help reduce the swelling. 2. Before the simulated arthrodeses, the talonavicular joint had the greatest range of motion (36.7 13 degrees [mean and standard deviation]), followed by the subtalar joint (20.4 8 degrees) and the calcaneocuboid joint (14.4 6 degrees), in all ten feet. This means that not enough bone is able to form for the joint to fully fuse. The soft tissues, including capsule and periosteum, are often disrupted. After this type of surgery, you can expect to lose some of your range of motion and feel stiff in your joint. WebMD does not provide medical advice, diagnosis or treatment. The differential threads combined with a low profile head apply a compression lock to the fragment. The plantar calcaneocuboid ligament (short plantar ligament) is a thick band of fibrous tissue that extends from the anterior tubercle of the calcaneus to the posterior part of the cuboid just behind the groove for the fibularis longus tendon 1. Then, theyll scrape away all the damaged cartilage (tissue) from your joint. Malik C, Najefi AA, Patel A, Vris A, Malagelada F, Parker L, Heidari N, Jeyaseelan L. Eur J Trauma Emerg Surg. Youll probably need to wear a cast or brace. The non-adherent antibacterial dressing is applied as a first layer. Your doctor might also choose to use a special manmade substance in place of an actual bone. Thetiming of surgeryis influenced by the soft tissue injury and the patient's physiologic status. [Reconstructions after inveterated fractures and dislocations of the foot]. All rights reserved. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Send us an email and we'll get back to you asap. Check for errors and try again. In the present study, we present our experience with newly developed rigid -tricalcium phosphate wedges to treat CCDA to better understand the outcomes of this synthetic bone grafting procedure. It causes the bones to become one solid bone, and it can lessen your pain. government site. MeSH Calcaneocuboid joint arthrodesis involves the fusion of the cuboid and calcaneus bones. An appropriate locking plate is selected to bridge the defect. Available in 2 to 6 hole configurations. New arthritis in nearby joints (very common). (for 6mm void) and 7.5mm dia. Publication types Review After spinal fusion Depending on the location and extent of your surgery, you may experience some pain and discomfort but the pain can usually be controlled well with medications. Such a plate or distractor must be removed subsequently to permit restoration of some joint motion. There is minimal movement occurring at this joint, with only some gliding motions during inversion and eversion. KNOW YOUR PRODUCT SAL. Each Screw package includes a series of self-adhesive labels for UDI compliance and comprehensive implant TRACEABILITY for hospital and patient records. How to Avoid Weight Gain During a Shut-Down, Cleaning Your House During the Coronavirus Outbreak, Cutting Through Chronic Pains Brain Fog, Protect Your Skin While Practicing Good Hand Hygiene, Exercises for Individuals with Multiple Sclerosis (MS) - Warm-up, Strength, Core and Balance, 4 Ways to Lower Blood Pressure Without Medication. Fixation with a locking compression plate (LCP) may be easier to perform while achieving compression perpendicular to the fusion site. This procedure can be technically challenging. Epub 2022 Mar 5. Fixation with a locking compression plate (LCP) may be easier to perform while achieving compression perpendicular to the fusion site. How it helps arthritis, migraines, and dental pain. "Triple" arthrodesis earned its name because it involves fusing the three joints of the hindfoot the calcaneocuboid, subtalar and talonavicular to correct the deformity. Epub 2010 May 28. (Calcaneocuboid labeled at bottom center. The plate needs to be contoured to achieve a good fit and prevent tenting of the skin. Therefore, the cuboid length must be maintained. For the first six weeks, you should not put any weight on your foot as it may disturb the healing joint. After they are finished, your surgeon will close your incisions with sutures or staples. Sci Rep. 2016 Oct 18;6:35493. doi: 10.1038/srep35493. Physical therapy can help keep your other joints in good working shape. The calcaneo-cuboid joint connects the hindfoot with the forefoot and is an essential structure during stance and gait. Please arrange for someone to take you home and look in on you in the first few days. Kafka RM, Aveytua IL, Choi PJ, DiLandro AC, Tubbs RS, Loukas M, Mintz DN, Baidya R, Kumar S, Sangari SK, Mtui EP, D'Antoni AV. There are five ligaments connecting the calcaneus and the cuboid bone, forming parts of the articular capsule: The calcaneocuboid joint is conventionally described as among the least mobile joints in the human foot. Fusion is one treatment option to relieve pain in patients who have a worn out joint due to arthritis or a traumatic injury. 14.17). (for 8mm void) by 40mm in length. Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study. The present study aimed to investigate changes in hallux alignment after corrective surgery for adult-acquired flatfoot deformity (AAFD).The present s The CoLag Screw design unites the rotational stability of a headless screw with the compression lag of a headed screw. Please enable it to take advantage of the complete set of features! Calcaneocuboid fusion The hindfoot consists of four bones and three joints. It may blend with the dorsal calcaneocuboid ligament and in such a case these two structures cannot be distinguished. It fuses together two bones, the talus and the navicular bone hence talonavicular fusion. Screws will be placed to allow the bones to heal together in proper alignment. Careers. Your bones are then positioned for the fusion. (for 6mm void) and 7.5mm dia. This article reviews the main conditions of the lateral column and calcaneocuboid joint in particular. bone block, lateral column lengthening; and. These new joints generally last about 10-15 years and the procedure is usually very successful. inflammatory pathoanatomy large forces seen by joints that have limited motion soft tissues that support joints see abnormally high forces over time results in midfoot collapse Presentation Symptoms midfoot pain (and in arch) with push off Physical exam inspection deformity shows longitudinal arch collapse with weight bearing Ensure that the splints medial and lateral vertical portions do not overlap anteriorly and that the splint does not compress the popliteal space or the calf. Insert the external fixator pins in the calcaneum through stab incisions, proximally in the calcaneum, and distally in the fifth metatarsal. Procedure. It may not display this or other websites correctly. ), Last edited on 19 February 2023, at 08:29, "Biometry of the calcaneocuboid joint: biomechanical implications", "The calcaneocuboid joint moves with three degrees of freedom", "Calcaneocuboid Joint Involvement in Calcaneal Fractures", https://en.wikipedia.org/w/index.php?title=Calcaneocuboid_joint&oldid=1140269367, This page was last edited on 19 February 2023, at 08:29. The talus, calcaneus, cuboid, and navicular bones are separated by cartilage and create the talocalcaneal, talonavicular, and calcaneocuboid joints. Or, it could come from a bone bank, which stores donated bones for use in surgeries like this. This type of surgery is performed under general anesthesia. In general, doctors believe this procedure is safe. INDIVIDUALLY PACKAGED Compression Screws are delivered in STERILE, cylindrical cases enclosing a series of capped sleeves. Until that happens, youll need to protect the area. Lateral column length is critical to maintaining the shape and function of the foot. A mesh plate can be used for larger defects and a cuboid plate for smaller defects. Subtalar pain may be mistaken for ankle pain. Fracture fragments are debrided and mobilized with a dental pick or Freer elevator. Representation of SAL (Sterility Assurance Level). Subtalar fusion is performed to either correct rigid, painful deformities or instability of the subtalar joint, or to remove painful arthritis of this joint. This video demonstrates a calcaneal cuboid fusion.