1st MPJ Arthrodesis with Locking Plate Debate

Check out this debate / point-counterpoint discussion on the necessity of using a locking plate or not when performing a 1st MPJ arthrodesis. Found in Podiatry Today's upcoming June issue, the discussion is held between Dr. Patrick Deheer, DPM, FACFAS and Dr. Shannnon Rush, DPM FACFAS.

Whichever side of the discussion you fall on, locking plates or conventional methods of fixation, all of your various fixation options can be seen at www.footandanklefixation.com on the 1st MPJ arthrodesis page.

New Ascension Mini Cal Plate

Ascension Products has added a new locking plate to their Total Foot Rearfoot System for calcaneal fractures that is smaller than the typical lateral plate. The plate comes in one size and is ideal when using a small lateral linear incision instead of the larger lateral extensile incision. Take a look below:

You can read more about the new Mini Cal plate as well as other Ascension Orthopedics here.
See all of your calcaneal fracture plating options here at www.footandanklefixation.com

More Mergers to Come??

With the recent acquisition of Synthes by Johnson and Johnson (Depuy Orthopedics) ($21.3 billion) and now Orthovita by Stryker ($316 million), one could anticipate that the device sector of the healthcare industry will continue to see an increase in mergers and acquisitions if current trends continue. In an interview with Medical Device Daily (FRIDAY, APRIL 22, 2011VOL. 15, NO. 73), Richard Cohen of the Walden Group, a strategic investment banking firm for the healthcare industry, explained how larger companies within the industry were forced into efficiency as a result of the down turn in the economy.

“Larger companies have come to realize that because of slower hospital market, capital budget constraints, reimbursement issues, and a tougher regulatory environment, core product lines are just slower to grow, Cohen said. “Overall it is harder to grow organically.” So these companies have larger balance sheets, cash in the bank swelling, difficulties growing organically, plus Wall Street is watching the stock prices quarterly, it’s really not possible to grow on one’s own and there are ample opportunities to grow by acquisition.”

With a handful of large companies within the foot and ankle device/implant industry, it seams only a matter of time before some of the midsized up and coming companies enter into the game of mergers and acquisitions. Check out the current fixation companies here at www.footandanklefixation.com.

First Experience with MMI Anchorage Cross Plates for 1st MPJ Arthrodesis

While using the MMI Anchorage Cross Plate (CP) for a 1st MPJ arthrodesis this am, all I could think about was how much easier the plate was making the case for me. I performed the typical joint resection and preparation for fixation application, however, this time I didn't have to worry about trying to place an interfragmental screw with the chance of interfering with one of the locking screws from the plate. The design of the plate made it very simple and straight forward.

Once the plate was positioned to my liking and secured with a guide pin, the plate was removed leaving the guide wire in place. This is where the bone was reamed out to make room for the recessed portion of the plate. This was easily accomplished by hand. Afterwards, the plate fit snuggly into place and was secured using two olive wires that came with the set. My only recommendations here are that (when positioning the plate in reference to the fusion site) you leave yourself enough room on the metatarsal head to create a large enough shelf of bone so that after the dorsal bone is reamed, you do not break out the distal dorsal cortex while inserting the interfrag screw. This did not happen in the case today, as the interfrag screw compressed the joint significantly but it could easily happen if the plate is applied to distal overall. From there on out it was smooth sailing and the remainder of the locking screws were inserted using standard technique and were easily accepted by the plate.

This plate offers something new that is not currently offered by any other company. The plate was not excessive and the design has clearly been thought out well as it was very easy to apply. It was very nice to watch as the the arthrodesis site compressed together with every turn of the compressive screw and with the plate already in position and secured, all I had to do was put in the remaining screws. Like fish in a barrel.

Wright Medical Announces Launch of Inbone II Ankle Implant

Wright Medical has announced the U.S. launch of their latest product in the Ankle Replacement field, the INBONE(R) II Total Ankle System. This new addition offers surgeons with broader implant offering including implant modularity, and improvements on their surgical intramedullary-guided instrumentation.

Outlined in their press release from May 10, 2011:

“The INBONE(R) II System is the only ankle replacement on the U.S. market that offers surgeons multiple implant options with different articular geometry. These highly anatomic implants are intended to permit the surgeon to tailor the amount of implant constraint or motion based upon the patient's unique anatomical demands. Improvements in the INBONE(R) II instrumentation are also intended to permit the surgeon to optimally place the implant components based upon each patient's biomechanical profile.”

You can find out more information on the Wright Medical INBONE(R) II Total Ankle System here and all U.S. available TAR / Ankle Joint Implant options at FootandAnkleFixation.com. 

MMI Anchorage Cross Plates for MPJ and Lapidus Arthrodesis

MMI has posted online their new Anchorage Cross Plating System for 1st MPJ arthrodesis and Lapidus arthrodesis. These plates are the first of their kind that incorporate the ability to place a lag compressive screw through the plate when performing an arthrodesis. As one high executive put it, "these plates are a game changer in the field of foot and ankle surgery."

I don't know about you, but I'm eager try out these new plates to see if they work as good as they look. It will be nice to have a guided compressive screw without the constant problem of interfering with crossing screws that are placed through the plate, as is the case with the current plating options.

You can read more about these new plates as well as other products offered by MMI at the following links:
Anchorage MTP CP Plate, Anchorage Lapidus CP Plate, All MMI Products.

Diabetic Ankle Fractures and Fixation Approaches

At some point or another, all foot and ankle surgeons will encounter the Diabetic Ankle Fracture patient in need of ORIF. Not only does the surgeon have to take into consideration the appropriate procedure and method of fixation but also the potential complications that may arise secondarily to the patient as a result of their medical history. Unfortunately, these patients are not always the healthiest of individuals and along with the ankle fracture can be a host of co-morbidities ranging from chronic tobacco use to cardiac disease.

There is a new article out of Orthopedics (Orthopedics May 2011; 34(5):385) titled Treatment of Ankle Fractures in Patients with Diabetes, that can be found on Orthosupersite.com. The article reviews the inherent problems with the Diabetic Ankle fractures as well as covers a handful of fixation options and approaches in treating the fracture. 

You can review all of the current internal and external fixation options for an Ankle Fracture, Fibular Fracture, Medial Malleolar Fracture, and Pilon Fracture at www.FootandAnkleFixation.com

OrthoPro Releases OrthoFlex Silcone Toe Implants

OrthoPro, has released their new implant for Hammertoe Correction; the OrthoFlex Toe Implant. Made of sillicone, these implants are an alternative to traditional arthroplasty, maintaining both digital correction and flexibilty. Read more about OrthoFlex here, as well as all of OrthoPro's foot and ankle Products here.