New Surgical Screws May Lead To Improved Arthrodesis Results

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By Aaron Becker, Special Projects Editor

The recent introduction of longer surgical screws may facilitate improved outcomes with lesser digital arthrodesis procedures.
The new Cannulated Titanium Lag Screws stand out with a thinner and longer profile, making them “ideal for severe digital deformities,” according to the manufacturer OsteoMed.
The 2.0 mm screw ranges between 6 to 42 mm in length and the 2.4 mm screw ranges between 6 to 50 mm in length. David J. Freedman, DPM, FACFAS, who is in private practice in Silver Spring, Md., says the screws are long enough that podiatric surgeons are able to complete an arthrodesis on the toe using “a very thin, small screw with a very thin head.”
Dr. Freedman notes the screws allow compression in comparison to K-wire fixation and this helps promote quicker healing. Dr. Freedman says the screws also help prevent mallet toe deformities that can be a complication with digital fusion procedures.

Why The Thinner, Longer Profile Makes A Difference
However, he notes the screw’s size is the main reason he uses it for digital deformity correction surgery above other screws. Dr. Freedman notes that other screws have been problematic due to being too wide in diameter or too short in terms of length. Dr. Freedman says the Cannulated Titanium Lag Screws’ head size also allows for a better outcome.
“If you put the implant up against the distal phalanx appropriately, (the patient) is not going to feel pain from the head of the screw,” says Dr. Freedman, who is an Adjunct Faculty member of the Baltimore-Washington Podiatric Surgical Residency Program.

Other Key Considerations
When using the screws in lesser digital arthrodesis procedures, Dr. Freedman says surgeons should ensure the K-wire is aligned through the shaft of each phalanx but use caution to avoid entering the metatarsophalangeal (MPJ) joint with the screw. One may use the K-wire after correcting an associated joint contracture of the MPJ. Dr. Freedman says this provides additional stabilization to the joint in the initial stages of healing. Dr. Freedman advises accurate placement of the screw head against the distal phalanx.
While Dr. Freedman says infection and breakage are possible, he has not seen these complications as of yet with these screws.
The Cannulated Titanium Lag Screws are indicated for bone fixation following trauma or osteotomy, according to OsteoMed.

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