How The Accu-Cut Guides DPMs Through Osteotomies
Citing enhanced stability, accuracy, efficiency and better outcomes, podiatrists are praising the benefits of using the Accu-Cut Osteotomy Guide System. While osteotomies for correcting first MPJ deformities have been around a long time, Robert E. Graser, DPM, says this system enables you to customize the procedure with ease and still obtain consistent results. “The tight tolerance engineered into the Accu-Cut Osteotomy Guide System allows surgeons to custom tailor their osteotomies via a simple method that is consistently stable and reproducible case to case,” explains Dr. Graser, who invented the system. The guide for specific procedures comes sterile packed with a custom blade and two 0.045 K-wires, according to Biopro, the system’s manufacturer. The company says the system features a simple mount and cut technique, which facilitates “fast and efficient performance of complex osteotomies.” It adds that “the two-point fixation of guide creates a stable platform for cutting osteotomy precisely every time.” Gerard Yu, DPM, says guide systems improve cutting accuracy and reduce the incidence of complications. “I use (the Accu-Cut) and feel anyone doing this type of surgery ought to use some type of guide to ensure the best possible cuts and therefore outcome,” explains Dr. Yu, a Fellow of the American College of Foot And Ankle Surgeons and the Director of Podiatric Medical Education at the St. Vincent Charity Hospital in Cleveland. “The device helps to decrease bone healing complications by ensuring a perfect hand and glove fit, so to speak.” Easing Concerns Over Complications Of The Chevron Procedure Biopro notes that using the Accu-Cut can address several complications in performing the common Chevron Procedure, which is indicated for pain associated with hallux valgus deformity and an inability to function in conventional shoe wear, among other indications. According to Dr. Graser, surgeons have traditionally performed Chevron osteotomies freehand or with relatively crude guide systems that lacked reproducibility and precision. However, changes in angulation, pitch or thickness of cuts often result in instability, difficulty in transportation and difficulty in obtaining or holding rigid fixation. “These factors allow excess motion within the osteotomy site that can lead to excessive edema and prolonged healing time,” explains Dr. Graser. However, the enhanced stability you get with the Accu-Cut may reduce these concerns. The company says the system has a few key features that address potential complications. These features include: • A fixed angle at 55 degrees. The company says this prevents the angle of the osteotomy from being either too small, creating intrusion into diaphyseal bone, or too large, creating an instability. • Tight tolerances between the blade and the saw guide. Biopro says this prevents any loss of bone substance by the saw and eliminates the convergence and divergence of osteotomy surfaces, prevents inadvertent PASA over-correction and reduces the likelihood of malunion associated with instability. • A longer custom blade. The company says this helps you ensure a complete through and through osteotomy. With these benefits, the company claims that the Accu-Cut can help you “create the most stable osteotomies possible” and allow you to achieve “rigid internal fixation … with near perfect apposition.” It says there is “less worry of prolonged edema and mal- or non-union” and the company claims the system facilitates quicker healing and a faster return to full function for the patient. While Mark Kravette, DPM, has only used the system three times, he believes the Accu-Cut has promise. “I think (the Accu-Cut) is a very handy device and creates very accurate cuts that reproduce and the osteotomies seem to be healing better,” notes Dr. Kravette. He says some DPMs like to create a long arm on their osteotomy devices and he is trying to find a way to do that with the Biopro device. How The Device Can Help With Surgical Modifications Dr. Yu has found the Accu-Cut to be helpful in performing modifications to a common procedure. “The device allows you to remove an extra segment of bone to shorten and/or plantarflex the capital fragment or metatarsal head for modifications of the Austin designed to assist in correcting hallux limitus deformity,” notes Dr. Yu. Dr.