Comparing Fixation Used for Calcaneal Displacement Osteotomies

Lucas, Douglas E.; Simpson, G. Alex; Philbin, Terrence M.

doi:10.1177/1938640014557073

Cited by 15 publications

(23 citation statements)

References 14 publications

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“…While this lateral plate and screw construct is more expensive than screws alone, one could argue that the decreased need to return to the operating room for removal of hardware leads to cost savings. Two studies in the literature have described hardware removal rates after calcaneal osteotomy, 4,5 and one of them did show a significantly higher cost associated with procedures that have a higher reoperation rate for hardware removal. Future studies looking at the cost analysis between plates and screws would be beneficial in elucidating this further.…”

Section: Discussionmentioning

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: 99%

“…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. A few other studies have specifically looked at lateral plates and shown lower rates of hardware removal, ranging from 6% to 22%, 5,8 but these studies had relatively small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

Review of Calcaneal Osteotomies Fixed With a Calcaneal Slide Plate

2019

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“…Some studies have suggested that the need for subsequent surgery for hardware removal may be lower using lateral plate fixation. 1,28 A percutaneously applied blade plate for fixation avoids the need for extensive soft tissue dissection, has a lower profile compared with use of a step plate, allows for compression across the osteotomy, and anecdotally has demonstrated sufficient strength to allow patients to begin weightbearing at 6 weeks in our experience. Lucas and colleagues 28 retrospectively evaluated 228 patients who underwent an open calcaneal osteotomy using a lateral locking plate (EdgeLock Plate; OrthoHelix Surgical Design, Medina, OH) in 63 patients and screws in 165 patients.…”

Section: Fixation Considerationsmentioning

confidence: 86%

Minimal Incision/Minimally Invasive Medializing Displacement Calcaneal Osteotomy

Sherman

Guyton

2017

Foot Ankle Int.

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“…Lucas et al 8 compared the cost of lateral plates and associated screws ($1157.59) with the cost of calcaneal screws ($247.12), and stated as well that the average cost of hardware removal was $10 937.02. 5 Hardware removal rates were reduced from 19.4% with headed screws to 1.6% in the lateral locking plate group, and the number needed to treat was 6 (CI = 4.1-9.1).…”

Section: Discussionmentioning

confidence: 99%

“…This savings potential is in agreement with that found in other studies in which headed screws were replaced by more modern hardware. 1,2,8 It should be noted that not all procedures involving headed screws will require postoperative screw removal. Foot and ankle surgeons should carefully consider their choice of implant during calcaneal osteotomy procedures because prominent hardware at the back of the heel may require subsequent surgery for removal of hardware.…”

Section: Discussionmentioning

confidence: 99%