Facilitating Increased Stability And Compression Across Fusion Sites

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Author(s): 
Podiatry Today Staff

For increased stability with fixation, a reduced risk of soft tissue impingement and improved efficiency in the OR, surgeons may want to consider the use of two new compression plates, the Anchorage Lapidus CP Plate and the Anchorage MTP CP Plate.

   The new compression plates are the latest additions to the Anchorage™ CP Plating Systems from Memometal (MMI). The company notes these plating systems offer cross joint fixation with compression and minimize the need for a separate transverse screw. All Anchorage CP Plates feature a low profile design and a unique, oblique screw, which provides an immediate stable construct, according to MMI.

   William Montross, DPM, cites the benefits of using the Anchorage Lapidus CP Plate.

    “By putting the compression screw through a locking plate, you get both the locking plate advantage as well as secondary fixation with compression,” explains Dr. Montross, a Fellow of the American College of Foot and Ankle Surgeons.

A Guide To The Procedure With The Lapidus CP Plate

In regard to the surgical technique, once you have achieved temporary fixation, MMI says you would attach the 1.2 mm locking drill guide to the Lapidus CP template. Then you can use the drill guide as a joystick to position the template over the joint, according to the company. Once you have verified the position, advance a 1.2 mm guide wire through the drill guide and into the metatarsal.

   The surgeon would subsequently remove the template and drill guide, leaving the 1.2 mm pin. MMI says the surgeon would then advance the CP reamer over the pin to the appropriate depth limit. Once you have completed the CP reaming, remove the guide pin, position the CP plate and hold it in place with temporary fixation. One would then implant the screws, beginning with the two most distal screws on the plate, according to MMI.

   Position the CP drill guide over the cross joint hole and perform appropriate reaming. MMI says surgeons should then measure to ensure screw length accuracy. Subsequently, one can remove all temporary fixation and place the appropriate non-locking screw through the CP hole. MMI notes that as the screw seats in the plate, additional tightening develops compression across the joint. Then the surgeon inserts the remaining proximal screws and verifies this via X-ray, according to MMI.

   Dr. Montross says the procedure is more efficient and has a minimal learning curve.

    “Locking plate technology is very standard and easy to master,” notes Dr. Montross, who is in private practice in Colorado Springs, Co. “The addition of compression through the plate makes (the Lapidus CP Plate) a better system.”

Another Option For First MPJ Fusions

The Anchorage MTP CP Plate is designed to facilitate fusion of the first metatarsophalangeal joint. MMI notes this product may be helpful in the treatment of severe hallux valgus, hallux rigidus and revisional procedures for non-unions, among other conditions.

   MMI says the Anchorage MTP CP Plate system includes a cannulated cup and cone reamers to help foster accurate joint preparation. The unique benefit of this system is the incorporation of the lag screw through the plate, which provides an immediate stable construct, according to MMI.

   Editor’s note: For a related PodiatryLIVE video, see http://www.podiatrylive.com/ Anchorage_First%20MTP_Lapidus_CP%20Plates .

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