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Clinical Solutions In Practice

Emerging Foot Plating System Offers Array Of Fixation Choices

Could one surgical hardware set offer a full complement of fixation options for fusions, osteotomies and fracture repair throughout the entire foot? 

According to Trilliant Surgical, the Arsenal Foot Plating System offers a variety of specialized plate and fixation options for the forefoot, midfoot and rearfoot. The system reportedly includes multiple sizes and configurations of fixation for Lapidus procedures, midfoot procedures, first metatarsal repair and medial column procedures, notes the company. Trilliant Surgical also notes the inclusion of a fifth metatarsal hook plate as well as rearfoot/calcaneal plates specific to procedures such as the Evans and calcaneal slide osteotomies. 

Jason Nowak, DPM, FACFAS uses the Arsenal Foot Plating System for a full array of surgical procedures including fusion of the first MPJ, midfoot procedures, medial column procedures and double or triple arthrodesis. He also frequently uses this system for trauma reconstruction and fracture care, such as calcaneal or metatarsal fractures, or Lisfranc injuries. 

Kyle Vaughn, DPM, FACFAS notes that he generally uses the Arsenal Foot Plating System for primary or revision fusions of the midfoot or hindfoot. 

Trilliant Surgical says the plates in the Arsenal Foot Plating System contain a Variable Angle Locking (VAL60) cone of 60 degrees (up to 30 degrees in any direction). The system’s multi-lock functionality reduces implant waste and saves OR time by allowing surgeons to lock and relock screws five or more times, according to the company. 

Both doctors cite the 60-degree variable locking screw placement as a standout feature as well as the screw locking mechanism that allows for less screw head prominence when inserting locking screws off-axis. 

“All screws in this set utilize a double-lead screw thread pattern, which allows for significantly faster screw insertion. This makes a significant difference in longer reconstructive cases when you are able to decrease surgical time,” says Dr. Nowak, the Director of the Northern California Reconstructive Foot and Ankle Fellowship. 

The company notes that locking and non-locking screws are available in 2.2, 2.7 and 3.5 mm diameters, and in multiple lengths. Trilliant Surgical adds that the system’s titanium alloy plates have vanishing edges that allow for minimal post-op palpability but do not sacrifice strength. 

“I recently performed a revision talonavicular fusion due to non-union,” says Dr. Vaughn. “In the setting of osteopenic, devitalized bone and a significant amount of bone grafting, the dorsal talonavicular fusion plate provided a stable construct that will give that patient an excellent chance at union.” 

Dr. Nowak, who is a consultant for Trilliant Surgical, shares that the Arsenal Plating System, in his experience, allows him to place locking screws into areas that otherwise pose challenges for fixation placement. 

“For years, we have had to rely on antiquated technology and derivatives of orthopedic trauma systems,” says Dr. Vaughn, who is in private practice in Phoenix, Ariz. “The locking technology of this system combined with the anatomic compatibility of the plating provides us with a modality which enables us to maintain stable reduction and fixation.” 

Clinical Solutions In Practice
By Jennifer Spector, DPM, FACFAS, Associate Editor
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