Triple Fusion


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Learn the Triple Fusion surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Triple Fusion surgical procedure.

The Triple fusion is  a versatile and successful intervention for treating both significant deformity as well as arthritic symptoms. The joints fused in this operation are the subtalar, talo-navicular and calcaneo-cuboid.

It is key that joint preparation is correctly done and that hind-foot and mid-foot alignment is restored. A CT or MRI is required in the majority of cases pre-operatively to adequately define the bone stock and level of deformity and identify all associated degenerative change.

Though the approaches used and techniques employed in the operation have changed little over the last thirty years a significant assistance to those performing has has been the development over the last ten to fifteen years of  large and compressive staples and locking plates to fix the midfoot joints. This technique demonstrates the use of an Orthosolutions cannulated large fragment screw to fix the subtalar joint and Wright Charlotte staples for the midfoot joints.

Functionality for most activities of daily living is little effected after a triple fusion but in the  longer term arthritis is likely to occur in the neighbouring joints.



Author:Mark Herron FRCS.

Institution: The Wellington Hospital, London

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity


Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


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