Comparison of Rates of Union and Hardware Removal Between Large and Small Cannulated Screws for Calcaneal Osteotomy

Sayres, Stephanie C.; Gu, Yang; Kiernan, Samuel; DeSandis, Bridget; Elliott, Andrew; O’Malley, Martin J.

doi:10.1177/1071100714549191

Cited by 16 publications

(14 citation statements)

References 13 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: 99%

“…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%

“…Numerous options of fixation for calcaneal osteotomies exist including various screws, plates, and staples. An abundance of literature on the topic has reached the conclusion that union rates are high following a calcaneal osteotomy regardless of fixation method, 2,3,[6][7][8][9] which is not surprising given the broad cancellous surface of the calcaneus and its rich vascular supply.…”

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: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Review of Calcaneal Osteotomies Fixed With a Calcaneal Slide Plate

2019

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“…26 There are various types of fixation used in MCO, but regardless of method, union rates after MCO are high, with studies reporting rates up to 97% to 100% with comparable rates of return to activity, hardware removal, and functional outcomes. 1,73,105,107…”

Section: Hindfoot Valgusmentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

149

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Adult-acquired flatfoot deformity (AAFD) comprises a wide spectrum of ligament and tendon failure that may result in significant deformity and disability. It is often associated with posterior tibial tendon deficiency (PTTD), which has been linked to multiple demographic factors, medical comorbidities, and genetic processes. AAFD is classified using stages I through IV. Nonoperative treatment modalities should always be attempted first and often provide resolution in stages I and II. Stage II, consisting of a wide range of flexible deformities, is typically treated operatively with a combination of soft tissue procedures and osteotomies. Stage III, which is characterized by a rigid flatfoot, typically warrants triple arthrodesis. Stage IV, where the flatfoot deformity involves the ankle joint, is treated with ankle arthrodesis or ankle arthroplasty with or without deltoid ligament reconstruction along with procedures to restore alignment of the foot. There is limited evidence as to the optimal procedure; thus, the surgical indications and techniques continue to be researched.

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“…Currently, there is little research concerned with studying the effectiveness of different implant types that may be utilized during calcaneal osteotomy. A study by Sayres et al 7 demonstrated that the use of smaller-caliber cannulated screws resulted in fewer postoperative revision procedures (screws were removed because of patient complaints of pain and discomfort) relative to larger-caliber cannulated screws. Abbasian et al 1 similarly demonstrated that the rate of screw removal was significantly higher in patients receiving headed screws as opposed to headless screws, but the sample size was much smaller than the one presented in this study.…”

Section: Discussionmentioning

confidence: 99%