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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Greisberg, Justin Vosseller, J. Turner Ferry, Chris Nash, Calvin Gardner, Thomas R. |
| Description | Country affiliation: United States Author Affiliation: Greisberg J ( Department of Orthopaedic Surgery, Columbia University Medical Center, 622 West 168th St, PH 11th floor, New York, NY, 10032, USA. jkg2101@columbia.edu.); Vosseller JT ( Department of Orthopaedic Surgery, Columbia University Medical Center, 622 West 168th St, PH 11th floor, New York, NY, 10032, USA.); Ferry C ( Department of Orthopaedic Surgery, Columbia University Medical Center, 622 West 168th St, PH 11th floor, New York, NY, 10032, USA.); Nash C ( Department of Orthopaedic Surgery, Columbia University Medical Center, 622 West 168th St, PH 11th floor, New York, NY, 10032, USA.); Gardner TR ( Department of Orthopaedic Surgery, Columbia University Medical Center, 622 West 168th St, PH 11th floor, New York, NY, 10032, USA.) |
| Abstract | BACKGROUND: When performing hindfoot arthodeses, one goal of fixation is often to achieve compression across the joint. Traditional lag screws are applied eccentrically, providing compression more on the edge of the fusion. A new technique, using a post in one bone and a lag screw through the post to the other bone, may offer better compression across more of the joint. METHODS: There are three parts to this study comparing a post-and-screw construct to traditional lag screws. Synthetic bone models, representative of the talonavicular joint, were created and assessed for biomechanical measures of compression. Next, the post-and-screw construct was tested in cadavers, under conditions representing early weight bearing after arthrodesis surgery. Finally, 18 patients who had a talonavicular fusion with a post-and-screw construct with one surgeon were compared to the previous 18 patients fixed with traditional screws. RESULTS: In the synthetic bone model, the post-and-screw construct brought the centre of compression closer to the centre of the joint, suggesting compression was less eccentric. Neither traditional screws nor the post-and-screw construct were sufficiently strong to resist early weight bearing forces in cadaver specimens. In the clinical comparison, four patients had a painful nonunion when fixed with traditional screws, compared to none in the post-and-screw construct. CONCLUSIONS: A post-and-screw construct spreads the forces of compression more uniformly across an arthrodesis, even when placed eccentrically. Although not all the biomechanical measures were superior, the post-and-screw construct achieved higher levels of successful fusion in patients. This technology may offer improved outcomes in some clinical scenarios and deserves further study. LEVEL OF EVIDENCE: Level 3. |
| File Format | HTM / HTML |
| ISSN | 03412695 |
| Issue Number | 11 |
| Volume Number | 39 |
| e-ISSN | 14325195 |
| Journal | International Orthopaedics |
| Language | English |
| Publisher | Springer |
| Publisher Date | 2015-11-01 |
| Publisher Place | Germany |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Orthopedics Arthrodesis Methods Foot Diseases Surgery Foot Tarsal Joints Adult Aged Aged, 80 And Over Bone Nails Bone Screws Cadaver Female Humans Male Middle Aged Models, Anatomic Pressure Tarsal Bones Weight-bearing Journal Article |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Surgery |
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