A Comparison of Removal Rates of Headless Screws Versus Headed Screws in Calcaneal Osteotomy

Kunzler, Daniel; Safavi, Pejma Shazadeh; Jupiter, Daniel C.; Panchbhavi, Vinod K.

doi:10.1177/1938640017744640

Cited by 11 publications

(15 citation statements)

References 8 publications

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“…Our rate of removal of hardware is lower than that reported in the literature, which has shown removal rates of hardware due to prominence/irritation between 6% and 50%. 1-3,8,9 As previously mentioned, numerous studies have correlated high rates of removal with the use of screws, particularly headed screws, for fixation of calcaneal osteotomies. 1,3 Our hardware removal rate was low even when compared with studies that evaluated the rates of removal of lateral plates.…”

Section: Discussionmentioning

confidence: 98%

“…1-3,8,9 As previously mentioned, numerous studies have correlated high rates of removal with the use of screws, particularly headed screws, for fixation of calcaneal osteotomies. 1,3 Our hardware removal rate was low even when compared with studies that evaluated the rates of removal of lateral plates. Abassian et al 1 note that 2 of 32 (6%) of the lateral plates were removed due to symptomatic hardware.…”

Section: Discussionmentioning

confidence: 98%

“…Hardware irritation leading to subsequent removal of the implant is common, and reported removal rates are high in the literature, ranging from 6% to 50%. 1-3,8,9 One recent study by Abassian et al 1 compared 3 different methods of calcaneal osteotomy fixation: a lateral locking plate, a headless screw, and a headed screw. They reported that 47% of the headed screws, 11% of the headless screws, and 6% of the lateral plates were removed to address symptoms from the hardware.…”

Section: Introductionmentioning

confidence: 99%

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Review of Calcaneal Osteotomies Fixed With a Calcaneal Slide Plate

2019

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Background: The calcaneal slide osteotomy is a common procedure used for the surgical correction of heel varus and valgus deformities. A variety of fixation methods exist including screws and plates. The literature shows a high rate of hardware prominence with screws leading to subsequent removal of hardware. Few studies have examined the use of plates for fixation of a calcaneal osteotomy. The purpose of this study was to assess outcomes following fixation of a calcaneal osteotomy with a calcaneal slide plate. Methods: This is a retrospective consecutive case series of all patients who underwent either a medial or lateral calcaneal slide osteotomy using the specialized calcaneal slide plate between September 2013 and December 2018 by a single surgeon. The primary outcome measures were the rate of hardware removal, healing of the calcaneal osteotomy, and any associated complications such as infection or incision healing delays. Patient baseline demographics and procedure-related data were recorded. The minimum follow-up was 4 months. A total of 81 procedures were performed using this calcaneal slide plate. Results: All of the patients had one or more additional procedures at the same time as the calcaneal osteotomy. All of the calcaneal osteotomies healed without displacement. Only 1 patient (1.2%) returned to the operating room and had removal of the calcaneal slide plate, which was after osteotomy union for an infected wound. There were no cases of hardware failure or removal due to it being symptomatic. Conclusion: A specialized calcaneal slide plate was an effective fixation device for both medial and lateral calcaneal slide osteotomies for a variety of foot and ankle conditions. The union rate was 100% and none of the patients had hardware symptoms, which is an improvement on published reports of symptomatic hardware after calcaneal slide osteotomy. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Review of Calcaneal Osteotomies Fixed With a Calcaneal Slide Plate

2019

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“…A simple solution to this was the suggested use of headless screws that allow burial below the cortical surface. (25) The dorsal-to-plantar technique has its own benefits and disadvantages as well. When osteotomy of the calcaneus or other indications listed above are not present, this approach allows simple supine positioning of the patient with a bump under the hip to bring the foot to a neutral rotation position, and only two fluoroscopy views are required to check position of the pin.…”

Section: ❚ Discussionmentioning

confidence: 99%

Biomechanical comparison of plantar-to-dorsal and dorsal-to-plantar screw fixation strength for subtalar arthrodesis

Chaudhari

Godoy‐Santos

Rodriguez

et al. 2020

Einstein (São Paulo)

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Objective: To compare screw fixation strength for subtalar arthrodesis. Methods: Eight matched pairs of cadaver feet underwent subtalar joint arthrodesis with two 7.3mm cannulated screws. Randomization was used to assign screw orientation, such that one foot in each pair was assigned dorsal to plantar screw orientation (DP Group), and the other foot, plantar to dorsal orientation (PD Group). Standard surgical technique with fluoroscopy was used for each approach. Following fixation, each specimen was loaded to failure with a Bionix ® 858 MTS device, applying a downward axial force at a distance to create torque. Torque to failure was compared between DP and PD Groups using Student's t test, with p=0.05 used to determine statistical significance. Results: Statistical analysis demonstrated that the mean torque to failure slightly favored the DP Group (37.3Nm) to the PD Group (32.2Nm). However, the difference between the two groups was not statistically significant (p=0.55). Conclusion: In subtalar arthrodesis, there is no significant difference in construct strength between dorsal-to-plantar and plantar-to-dorsal screw orientation. The approach chosen by the surgeon should be based on factors other than the biomechanical strength of the screw orientation.

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“…Studies may also use other measures such as infection, amputation, and revision rates to determine the success of various procedures. 6,7 The purpose of this review is to determine which outcome measurement tools are most frequently used in the recent literature and also to discuss some of the issues concerning these widely used resources. A second search with similar criteria was performed, limited to publications in the following journals: Foot and Ankle Specialist, Foot and Ankle International, Journal of Bone and Joint Surgery American, Journal of Bone and Joint Surgery British, Journal of Orthopaedic Trauma, Journal of Foot and Ankle Surgery, and European Foot and Ankle Surgery.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of the Outcome Evaluation Tools for the Foot and Ankle

Safavi

Janney

Jupiter

et al. 2018

Foot & Ankle Specialist

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Background. The goal of this systematic review is to determine the most commonly used outcome measurement tools used by foot and ankle specialists and determine their limitations, such as whether they are validated, have floor/ceiling effects, and so on. Methods. A literature search was conducted to identify primary publications between January 1, 2012 and July 1, 2017 that concern care of the foot and ankle and use any established grading criteria to evaluate patients. Results. In 669 publications, 76 scoring systems were used. The 10 most common were American Orthopaedic Foot and Ankle Score (AOFAS), visual analog scale (VAS), Short Form–36 (SF-36), Foot Function Index (FFI), Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), SF-12, Short Musculoskeletal Function Assessment (SMFA), Ankle Osteoarthritis Scale (AOS), and Foot and Ankle Disability Index (FADI). AOFAS was used in 393 articles, VAS in 308, and SF-36 in 133 publications. AOFAS, VAS, and SF-36 were used to evaluate 23,352, 20,759, and 13,184 patients respectively. AOFAS and VAS were used simultaneously in 172 publications. Conclusion. While there are many different scoring systems available for foot and ankle specialists to use to assess or demonstrate the effectiveness of treatments, the AOFAS, while it is an unvalidated scoring system, is the most commonly used scoring system in this review. Clinical Relevance. This review presents data about commonly used patient reported outcomes systems in foot and ankle surgery. Levels of Evidence: Level III: Systematic review.

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A Comparison of Removal Rates of Headless Screws Versus Headed Screws in Calcaneal Osteotomy

Abstract: Level IV.

Cited by 11 publications

References 8 publications

Review of Calcaneal Osteotomies Fixed With a Calcaneal Slide Plate

Review of Calcaneal Osteotomies Fixed With a Calcaneal Slide Plate

Biomechanical comparison of plantar-to-dorsal and dorsal-to-plantar screw fixation strength for subtalar arthrodesis

A Systematic Review of the Outcome Evaluation Tools for the Foot and Ankle

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