Evolution of the Locking Plate

As locking plates emerged over the past decade, new advances and technologies have continued to evolve. Looking back, it’s hard to forget the classic AO video demonstrating pullout strengths between locking and non-locking 3.5mm cortex screws while applying a cloverleaf plate to an apple. As if the video wasn’t convincing enough, numerous studies and publications further backed the increased stability achieved with the locking constructs. Needless to say, interest in locking plates steadily grew as they became sought after particularly in cases of unstable trauma, revisional surgery and osteopenic bone.

With major companies like Synthes leading the way with newer locking technology, along came the locking drill guide. This added precise accuracy when pre-drilling. Now the drill hole would maintain a centralized position aligning and locking the screw properly with the plate threads. Simple enough right? Not exactly. Problems can still arise

· Alteration of the locking construct following bending of the plate

o Likely the most common cause of problems

o Inherently alters the integrity of the plate threads disrupting the screw from seating properly within the plate.

· Not inserting the screw directly 90 degrees to the plate

o The screw head will not seat properly within the plate

o Can cause the metal to strip or peel off the head

o If enough force is applied, the head of the screw can actually break off

These downfalls can lead to failure with the locking construct and/or neutralize their locking effect, essentially making them no stronger than a non-locking plate. Fast forward to today. New advances in locking plate technology have evolved such that it gives the surgeon additional room for error when applying a locking plate.

Examples:

· The Depuy plating systems

o Pre-loaded locking guides on the plates

- Eliminates the sometimes frustrating step of trying to get the drill guide to properly load into the plate

- Enables the surgeon the ability to bend the plate without disrupting the plate threads

· Smith & Nephew plates

o Variable angle capabilities.

o Now the screw does not need to be directed in precisely at 90 degrees

Some plates have eliminated the need for threads within the plate holes altogether:

· Extremity Medical IoFix Implant

o Although not a plate per say, the IoFix implant utilizes the locking plate idea. Based on the conical shape of the screw head, the screw essentially locks into the post as it is inserted.

· Integra Hallu-Lock Plate

o Utilizes a SurFix system

- There are no threads on the head of the screw

- Instead, a separate threaded washer, applied on top of the screw head, after the screw is inserted

Can traditional non-locking plates get the job done? Probably in most cases, yes. Do locking plates offer multiple advantages over standard plating options? Most definitely. Ultimately, the choice to use these new plating options rests in the hands of the surgeon. Regardless, advances in plating technology have and will continue to evolve, making it not only easier for the surgeon but also superior for the patient.

- www.FootandAnkleFixation.com

Social Fixation

FootandAnkleFixation.com embraced the world of social media this week with Twitter @SurgFix, Facebook, Google+ and LinkedIn.

Of course you can follow our blogs directly and we welcome you to our Community. Please join us as we ease your navigation into the world of surgical implants of the foot and ankle!

New Product: HemiCAP® Talar Resurfacing Implant

With all of the hype surrounding Ankle Joint Implants / TAR, a new implant has surfaced on the market (no pun intended) from Arthrosurface. The Hemicap Talar Resurfacing Implant is different in the sense that it is not a Total Ankle Replacement, but is designed for more specific or focal talar dome defects. Arthrosurface has taken the technology from their Hemicap DF System for 1st MPJ resurfacing and applied the same concept to the new talar implant. The device has a cobalt chrome articular surface with the undersurface coated in Titanium.

As stated on the Arthrosurface website, "The HemiCAP system is intended to provide an effective interim means for managing pain and disability in the middle-aged patient until a total joint replacement treatment option becomes more necessary, and is part of a clinical treatment strategy to help avoid early-age-revision scenarios. The prosthetic may also provide a treatment option for the older patient who may not tolerate the morbidity of a total joint replacement procedure."

This implant is not yet available for use in the United Sates or Canada. However, it is cleared in Europe and Arthrosurface has a program set up through which pateints can connect with physicains overseas. FootandAnkleFixation.com offers many informative services to foot and ankle surgeons, and we strive to provide up-to-date product news and information that we feel is pertinent to your practice. Unfortunatly, we do not include non FDA cleared products in our comprehenisve database. We will bring attention to those that are either on the verge of being cleared or that we feel are potentially industry changing. This is an exciting new option for reconstructive ankle surgery and we look forward to the opportunity when we can explore this implant further

The IoFix Experiment

Yesterday I finally had an opportunity to give the Extremity Medial IoFix implant a try. The patient had a history of osteoporotic bone (as noted in her previous hallux abducto valgus correction) therefore, I sought out a new implant that could help manage the frailness of the bone. And as expected, I was not disappointed.

As with most new implants and instrumentation, putting the first post and screw in took a few extra minutes. However, with this device, the learning curve was quick and the second construct was inserted in a noticeably faster application. One caveat that I can pass along is that I accidentally overdrilled past the laser-etched mark (on the drill) prior to inserting the second post. The over drill is very sharp and in this case when combined with soft bone caused the post to fit loosely within the bone. Although this error on my part was negated with the final screw purchase, pre-drilling for the post prior to screw insertion should not be overlooked.

Overall, the construct was very solid and I was impressed by the way it essentially neutralized the porosity of the patient's poor bone quality. A few of the tips that are demonstrated in this technique video were utilized during the case and really helped me with screw placement. This prevented contact between the two interfragmental screws. The next time that you are preparing for an arthrodesis procedure, consider looking into the Extremity Medical IoFix Implant. If you are concerned about wall breakout or osteoporotic bone, using this implant is a no-brainer.

All Extremity Medical products are viewable here at www.FootandAnkleFixation.com

The Unbiased Authority: There are no conflicts of interest or financial association/assistance between FootandAnkleFixation.com and Extremity Medical

Trends in Hammertoe Surgery

Traditional fixation methods for Hammertoe Correction include cerclage wire and external k-wire fixation for the past 40 years. As of recently though, these traditional methods have been challenged by new fixation options such as screws (BioPro Digital Compression Screw, Vilex Digital Fusion Toe Implant), staples (SBI StaFix Staples), and suture anchors (Core Essence ReNOVO). Additionally, a new breed of hammertoe implants has become increasingly popular including Nitinol shape memory implants, (BME Hammerlock, Stryker (MMI) Smart Toe), peg and hole implants (Wright Medical Pro-Toe VO, Tornier StayFuse), and now Arrow Tipped Implants (Arrowhead ARROW-LOK).

But does it all make a difference? Do these new techniques have an advantage over the standard k-wire? In most cases, the external k-wire is fast, technically straightforward, and inexpensive. Unfortunately with this technique, patients have the added morbidity of a pin protruding out the end of their toe(s), the possibility of a pin tract infection and the anxiety and discomfort involved with removing the pins. There’s a saying that you can’t teach an old dog new tricks, but this may be one worth trying, as newer fixation methods for hammertoe correction can offer some patients a better option.

Specifically in regards to hammertoe implants, three different types have evolved and are now available on the market. First, the memory shape metal implants have taken off in recent years and have become popularized as one of the go to standards in internal options. The BME Hammerlock and the MMI Smart Toe are two Nitinol implants available that have received the most attention and have really opened the door for similar implants to follow. The drawback to these implants is the specific temperature requirement needed to store the implant prior to insertion along with the time sensitive nature of the implant once it is removed from its cryo-preserved state. If the implant is not inserted in a timely manner, the arms of the device can open, hindering the implant’s insertion. Additionally, the implant does have the ability to break over time if stressed above and beyond its modulus of elasticity. In most instances, this does not lead to problematic symptoms and can be monitored over time. Take a look at the new BME Speed as it has eliminated the need for temperature regulation while still utilizing the benefits of the nitinol.

Next up are the peg and hole type implants such as the Tornier StayFuse implant and the Wright Medical Pro-Toe VO. Rather than inserting a time sensitive implant whose legs expand with body temperature, these implants are directly inserted into both ends of the fusion site. From there, the two independent pieces are joined together, creating a stable construct. Lastly and the most recent implant to come to the table is the Arrow-LOK implant. A variation from a buried k-wire, this implant is the most straightforward and simple implant on the market. Even so, initially it is technically demanding and takes a few reps before it becomes second nature (which it does). The 3-dimensional arrow tipped implant is available in both straight and angled options.

So in the end there are a variety of options that surgeons can choose from when correcting hammertoes. The gold standard has been the external k-wire, however, newer implants (at a cost) have demonstrated predictable results with added patient benefits. These new generation implants offer patients the option of internal fixation and potentially less morbidity.

New Company: Nextremity Solutions

Although there are thousands of medical device companies within the orthopedic industry, companies specifically focusing on foot and ankle surgery is somewhat limited. And so it is with great pleasure that FootandAnkleFixation.com is pleased to announce the addition of our 51st foot and ankle medical device company: Nextremity Solutions.

This up and coming orthopedic implant company announced the acquisition of its CE Mark for the Nextra™ Hammertoe Correction System in late November. Next up on their to do list will be the official launch in the U.S.. Specific information and images of the new implant have not been officially released, however, in speaking with a source close to the product's development, the new implant focuses on enhancing the fusion site by way of newly developed technology incorporated into the overall implant design. Check back often with us as we will highlight any information that is released regarding this new technology for Hammertoe Correction.

New Product: Vilex Digital Fusion Toe Implant

One of the hot topics recently in foot and ankle surgery are the continual evolution of fixation options for Hammertoe Correction. We have seen a variety of implants hit the market within the last few years that have offered different advantages over the competition. In keeping tract of all of the available internal and external fixation options for foot and ankle surgery, FootandAnkleFixation.com is proud to announce the newest implant added into the database; the Vilex Digital Fusion Toe Implant. The hammertoe implant is now live online and available for use in the U.S.

Currently there is no surgical brochure on the screw to download, however, the cannulated screw appears to involve a simple insertion following joint preparation. Screw sizes include 2.0mm, 2.5mm, and 3.0mm and is available in sizes ranging from 24-50mm.

New Product: Vilex Opening Wedge Plate

Looking for a plating option for correcting a Hallux Valgus deformity with an Opening Base Wedge Osteotomy, well look no further. Check out the Hallux Abducto Valgus: Opening Base Wedge page on FootandAnkleFixation.com

Recently added to the online fixation database was the Vilex Opening Base Wedge Plate. The product is now live on the Vilex website along with a PowerPoint slide presentation from start to finish on how to apply the plate for Hallux Abducto Valgus correction. There is no pdf brochure on the plate to download, however, the step wise procedure and information is now viewable. To read up more on this new plate for bunion correction, visit the Vilex Opening Base Wedge Plate product page here.

Interested in what else Vilex has to offer, you can see all of their available foot and ankle products by visiting the Vilex product pages here.

Arthrosurface: New Website

Here at FootandAnkleFixation.com, we try not to get bogged down in the corporate side of medicine that you'll find in most orthopedic online websites. Our goal is to present only fixation product updates that will make a difference in your daily practice. With that said, every now and then there are changes within the industry, that we feel are important enough to bring attention to. Arthrosurface, makers of joint resurfacing systems, have upgraded their website and product pages to a more surgeon friendly site where all of their product information is very accessible. It is very easy navigate through their site and find product literature, videos, and general media content.

As Arthrosurface has helped to make it easier for you as a surgeon, unfortunately, most other device companies have not. Thus the idea behind creating SurgicalFixation.com. Our goal is to create an online resource where you can go for all of your Fixation needs without the need to waste time searching for implant information. Like Arthrosurface, we have created a user friendly platform for where you can find product information by procedure including product brochures, product literature, and quick tip videos. Give it a try, start by looking at the Arthrosurface products here.

Fixation Network: Solana Surgical

A new video on the Solana Surgical Metatarsal Decompression Implant has been added to the Fixation Network. The video highlights this new 1st MPJ implant and demonstrates the insertion sequence. Check out the newly added video in The Fixation Network. You can read more about Solana Surgical as well as the Metatarsal Decompression Implant here at FootandAnkleFixation.com.

The Orthopaedic Implant Company (OIC)

FootandAnkleFixation.com is happy to announce the addition of The Orthopaedic Implant Company (OIC) to our Fixation Community. OIC is a Nevada based company currently offering 7.3mm cannulated screws. The screw features a low-profile head, reverse cutting flutes, and is self-drilling & self-tapping.

We will continue to bring you more information and product highlights from the OIC as they are brought to market.

Solana Surgical Now Online

FootandAnkleFixation.com is pleased to announce the addition of Solana Surgical. This global orthopedic company currently offers the Metatarsal Decompression Implant for Hallux Rigidus and Hallux Valgus assocaited with arthritis. The hemi implant is Titanium based with a Cobalt Chromium coating and is available in 4 different sizes. You can read more about the Metatarsal Decompression Implant as well as watch the implant's insertion sequence here.

New Product: BME Speed

Biomedical Enterprises (BME) has announced the release of their latest implant, the Speed. This Nitinol staple is designed to facilitate intraoperative technique and overall ease of insertion. The Speed system comes pre-loaded and the Insert-n-Twist action is used to unlock the staple upon insertion without the need for heat activation.

Read more about the Speed and all other available BME products at FootandAnkleFixation.com

Zimmer Acquires ExtraOrtho

Zimmer Orthopedics has announced the acquisition of ExtraOrtho, Inc. This further enhances the external fixation line offered by Zimmer, as the merger adds the XtraFix External Fixation System to their foot and ankle product line.

“This acquisition further enhances Zimmer’s position in the vital and growing external bone fixation market,” said Jeff Paulsen, President, Zimmer Global Businesses. ”The XtraFix technology is one of the most simple and effective solutions for external fixation, and we’re confident that trauma care professionals will welcome this addition to Zimmer’s comprehensive portfolio of external and internal fixation products.”

Both foot and ankle product lines are viewable at FootandAnkleFixation.com

More Fixation Articles

On the heels of the October edition of Clinics in Podiatric Medicine & Surgery, in which the entire journal was dedicated to the Advances in Fixation Technology in foot and ankle surgery, the Journal of Foot and Ankle Surgery now has a similar issue. Their November edition has 12 articles that specifically involve new findings and techniques with a variety of surgical fixation, including the Arthrex Tight Rope suture button, Gramedica HyProCure arthroereisis, Wright Medical Inbone total ankle replacement implant, Smith and Nephew Taylor Spatial Frame, and the Box total ankle replacement. Additionally, there are publications that involve screw fixation versus locking plates, external fixation with callus distraction, and new techniques with both screw fixation and wire fixation.

Whether new concepts are presented for the first time or previously described methods are further supported, these publications help aid in the overall evolution of foot and ankle surgery. Our goal at www.FootandAnkleFixation.com is to help create surgical awareness about your fixation options, as it not only impacts you as a physician but also your patient.

Advances in Fixation Technology

We here at SurgicalFixation.com were excited and enthused when we came across the recent October publication of Clinics in Podiatric Medicine and Surgery (www.theclinics.com). The issue is dedicated to “Advances in Fixation Technology for the Foot and Ankle”. This collection of articles proves exciting for us as it demonstrates that there is value in our work of aggregating fixation information.This publication also validates the importance of staying informed about what’s available for use in surgery, as this knowledge will continue to drive the evolution of foot and ankle technology and ultimately the nature of foot and ankle surgery. Clearly put, as fixation technology continues to evolve, there is a direct impact on surgical techniques and surgical standards. This directly impacts you as a surgeon and ultimately the patient.

One of the more noticeable advancements in surgical fixation technology in recent times is the evolution of the locking plate. Most surgeons by now are familiar with the “apple video” that demonstrates the effective pullout strength comparison between non-locking and locking screws. This technology has rapidly evolved as the standard in fracture fixation and is becoming increasingly more common in elective surgery. One article in the October edition of The Clinics in Podiatric Medicine and Surgery, Locking Plate Technology and Its Use in Foot and Ankle Surgery, reviews this innovation and its impact on foot and ankle surgery.

At SurgicalFixation, we echo consulting editor Thomas Zgonis when he says that advances in fixation technology for the foot and ankle are simply evident by the seemingly endless stream of new products within the field. We couldn’t agree more, and this is the premise for developing www.FootandAnkleFixation.com. New products will continue to shape the future of foot and ankle surgery and our authoritative resources will continue to strive to broadcast the most up to date surgical fixation information, thus keeping surgeons maximally informed and prepared.

Stabilization with HyProCure Implant

Arthroereisis implants for subtalar joint instability have become a fast and reliable procedure for foot and ankle surgeons. Dr. Michael Graham, DPM of the Graham International Implant Institute has released a paper this month (J Am Podiatr Med Assoc 101(5): 390-399, 2011) on his findings with the implant in a 5 limb cadaveric study. In measuring the forces distributed across the posterior and anterior facets of the subtalar joint, Dr. Graham concluded that placement of the implant in a hyperpronated foot prevents excessive talar subluxation and assists in proper distribution of the axial loads on the subtalar facet joints. More information on the HyProCure implant can be found here. All availble Subtalar Joint Implants / Arthroereisis can be seen here, at www.FootandAnkleFixation.com

As it is our goal to preserve the unbiased nature of the content on FootandAnkleFixation.com, it is important to acknowledge that Dr. Graham has a financial association with the HyProCure Implant.

New Orthfix Product: Centro Nail

Orthofix is now marketing their latest foot and ankle product, the Centro Nail. This Intramedullary Nail is ideal for Pantalar / Tibiotalocalcaneal Arthrodesis in Charcot breakdown and severe degeneration of the rearfoot.

Currently the Orthofix website has not been updated with content for the Centro Nail and once it is live we will have images and a link available; currently you can check out the specs on the Centro Nail product page on FootandAnkleFixation.com. After seeing this implant up-close, the IM Nail offers surgeons two noticeable advantages. First, the arm to the targeting guide can rotate 360 degrees around the nail, eliminating the need to reposition the nail base. Second, there are adjustable guide holes in the arm of the targeting guide that enables surgeons the ability to place screws without coming into contact with nail. Both of these additions should help to expedite intra-operative techniques.

All current Orthofix foot and ankle products are viewable here.

Total Ankle Replacement Review

Podiatry Today has a good review on Ankle Replacement surgery and the Total Ankle Replacements (TAR) that are available for use in the United States. They break down each implant and give thier experiences with the implants that they have used. Take a look at this article by Drs. Robert W. Mendicino, DPM, FACFAS, Alan R. Catanzariti, DPM, FACFAS, and Kyle S. Peterson, DPM out of the Western Pennsylvania Hospital in Pittsburgh

For futher information on the Total Ankle Replacments / Ankle Joint Implants that are currently available, FootandAnkleFixation.com has all of the information organized for you. Check it our here.

It's Official: Integra & Ascension Merger

As previously reported on FootandAnkleFixation.com, Integra LifeSciences and Ascension Orthopedics entered into an agreement to merge under the Integra Brand on September 12, 2011. Now it's Official.

Per their website, Integra has announced that the merger is complete and the Ascension line of foot and ankle products are currently being integrated in with their product line. In addition to the plating and screw systems, this acquisition will bolster Integra’s foot and ankle product line to include pryocarbon technology, specifically with the PryoSphere TMT implant for Lisfranc Joint Arthrodesis.

As this merger continues to evolve, FootandAnkleFixation.com will continue to bring you the latest news and information involving their foot and ankle product lines. Stay tuned for more information.

Integra LifeSciences to Acquire Ascension Orthopedics

Integra LifeSciences has announced that they have reached an agreement to acquire Ascension Orthopedics for $65 million in cash. The deal annoucned this morning on the Integra homepage.

 

"Ascension is an ideal strategic fit for Integra, as it reinforces our commitment to and presence in the fast-growing extremities space," said Stuart Essig, Integra's Chief Executive Officer. 

Check out all of the Integra LifeSciences foot and ankle products here and all of the Ascension Orthopedic products here.

New Ascension Products Online

We have uploaded 5 new Ascension Orthopedic Products into our database, as these were just launched. Included in their new product line are modifications on their MPJ Fusion Plate, Opening Wedge Plate, and their Mini Calc Plate. Additionally, they have introduced a new 2 & 3 hole plate as well as a 10-hole plate to their Tarsalis Line. 

Take a look at the new plates:

Ascension Orthopedics MPJ Fusion Plate (Long)

Ascension Orthopedics Opening Wedge Plate (Modified)

Ascension Orthopedics Mini Calc-Long Plate

Ascension Orthopedics 2 & 3 Hole Plate

Ascension Orthopedics Long Straight Plate

All Ascension Orthopedics Products

Circular External Fixation Course

The American College of Foot and Ankle Surgeons is holding a two and a half day program on the ins and outs of circular fixators. The event will take place in Scottsdale, AZ at the FireSky Resort over the 28-30th of Ocotber. 

The fee for ACFAS Members and residents is $895, non-members is $1095. The course is worth 22 CME hours and you can register here.

Fixation Network: Tiger Cannulated Screw

We have uploaded a new video to The Fixation Network. The Trilliant Surgical "Tiger" Cannulated titanium screws come in 2.0, 2.4, 3.0, and 4.0mm diameters. These screws have demonstrated excellent bone purchase and are nice option for forefoot procedures such as in Hallux Abducto Valgus: Distal Osteotomy procedures. 


The new video demonstrates how to insert the 3.0mm cannulated screw. The sequence is very straightforward and the screw can be a solid addition to any surgeon's repertoire of implants to choose from.


The Fixation Network is brought to by Foot & Ankle Fixation.com

Hammertoe Challenges & Foot Innovate

Footinnovate.com and presenter Dr. Robert Anderson, MD will be hosting an online training session Hammertoe Challenges next Wednesday, August 31, 2011. With Wright Medical Technology participating with the session, I can only imagine that the discussion will involve their new hammertoe implant, the Pro-Toe VO.  

The Pro-Toe VO was released to the market earlier this year and is one of the latest options on the market that enables foot and ankle surgeons and patients the option of burring the implant internally as an alternative to the traditional external K-wire. The above link will lead you to more information about the Pro-Toe implant, while you can see all current Hammertoe implant options here. 

Limb Deformity Course Sept. 1st - 4th

The 21st Annual Baltimore Limb Deformity Course will be held this upcoming September 1st - 4th and includes the Pre-Course on Ponseti Clubfoot techniques as well as the Post-Course on Advanced Training with the Taylor Spatial Frame. The courses will cover multiple topics including application of internal & external fixation such as monolateral / circular external fixation and fixator-assisted plating and nailing.

Surgeons can still register for the course here.

New Fixation Network Video

Check out The Fixation Network as we have uploaded a new video sequence on inserting the Extremity Medical IoFix Implant. The video walks you through step by step from start to finish on inserting the implant and points out a few tips and tricks for making your case run more successful. The video focused on performing a calcaneocuboid joint arthrodesis, however, the implant can be used in multiple areas of the foot and ankle. Enjoy.....

Arrowhead Website Now Live

Information about the new hammertoe implant Arrow-Lok Digitial Fusion System, manufactured by Arrowhead Medical Devices Technologies, can now be accessed online as their website has officially launched. The new website is user friendly and visitors to the site have the ability to navigating through topics such as Surgical Tips & Tricks, Instrumentation, Instructions For Use, and Performance Testing Results.

Arrowhead Medical Devices Technologies, founded in August of 2010, specializes in developing medical devices for the treatment of musculoskeletal conditions. The Arrow-Lok Digital Fusion System is the first product for the company.

Medshape Cleared for IM Ankle Nail

Medshape Solutions have announced on their website that they have received FDA 510(k) clearance for their DynaNail Intramedullary Fusion Nail. According to the announcement,  

“The DynaNail’s unique, patented design utilizes shape memory alloy technology to actively adapt to changes, such as local bone resorption, in the arthrodesis (fusion) site. By adapting to such changes, the DynaNail may better maintain close apposition of the bones and compression across the fusion zone during the healing process.

The DynaNail device, intended for tibiotalocalcaneal arthrodesis procedures, incorporates an innovative shape memory internal element that is simply stretched during the insertion procedure. Once the nail is fixed in place with screws, the shape memory alloy element maintains the target fusion bones in close apposition and under sustained compression for longer time periods than static, non-adaptive intramedullary devices. Surgeons implant the DynaNail using a surgical technique similar to that of traditional ankle fusion nails, thereby dramatically reducing the learning curve required for the new technology.”

This will be the first intramedullary fusion nail on the market that is designed utilizing memory shape alloy technology for use in the Pantalar / Tibiotalocalcaneal Arthrodesis. This will be Medshape Solutions second foot and ankle medical device; they currently carry the Morhpix Bone Anchor.

Orthopaedic Trauma Resident Fracture Course

The Orthopaedic Trauma Association is holding the 2011 Comprehensive Fracture Course for Residents this October at the Henry B. Gonzales Convention Center in San Antonio, Texas. The course will be from October 12-15 and will focus on all aspects of orthopaedic trauma care, including fracture stabilization and fixation techniques. You can print off the registration form here.

New Fixation Network Video

As FootandAnkleFixation strives to keep you up on the latest in foot and ankle implants and medical devices, we have also been in the process of creating The Fixation Network. This section of our website is designed to show you tips and pearls on a variety of implants and particularly in a quick and to the point fashion. The videos shorts are to help show you step by step the sequence for inserting new products, as well as to share tricks that may help facilitate intra-operative decision making.

Our first video is now up and demonstrates how the use of the drill guides can help facilitate the talonavicular fusion portion of the triple arthrodesis when using the Extremity Medical IoFix Implant. The drill guides can help show you where the IoFix Implant will be inserted as well as the placement for the corresponding screw. This is important, as if inserted incorrectly, the talonavicular screw may contact the subtalar joint arthrodesis screw. Watch below.

You can visit The Fixation Network here on the home page of FootandAnkleFixation.com

Medical / Surgical Mission Recap

Congratulations to all of those who participated in last week's medical / surgical mission trip to Comayagua, Honduras last week. With the aid of the International Foundation of Reconstructive Surgery, roughly 125 patients were treated in the clinic for foot and ankle issues and 30 patients underwent foot and ankle surgery. Procedures ranged from basic soft tissue pathology to more complex reconstructive procedures. Thank you to all of those who helped sponsor the mission and to those who donated medical supplies and implants. Check out a recap of the week below.

For those interested in how they can donate to the cause or get involved, you can read more about the foundation here.

New OrthoHelix Products

In an email released August 1st, OrthoHelix Surgical Designs has released information on two new products set for launch in the United States. The first product displayed was the OrthoHelix Distal Tibial Plate for procedures including Ankle Fractures, Medial Malleolar Fractures, or Pilon Fractures. The new OrthoHelix Distal Tibial Plate is anatomically contoured to sit anteriorly to avoid contact with the posterior tibial tendon and is intended to stablize fractures of the medial malleolus.

The second product set for launch is the OrthoHelix Mini MaxLock Extreme ISO Plate. This new plate, also known as the Intraosseous Sliding Osteotomy Plate, is geared towards plate fixation of a distal osteotomy for Hallux Abducto Valgus surgery. The first of its kind, this plate allows two screws into the capital fragment while at the same trime permitting the introduction of an interfragmentary screw into the body of the metatarsal with their PocketLock Technology. This is similar to the MMI Anchorage CP Plates for 1st MPJ Arthrodesis and Lapidus Arthrodesis that recently hit the open market, yet this ISO plate is the first of its kind for a distal bunion procedure. Stay tuned for when the full specs are released and our full review of these new products.