reconstructive and fusion procedures a non-inventor centre ... · • variable angle (va) synthes...
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VA SynthesTM Locking Plates in the use of Foot Reconstructive and Fusion Procedures
A non-inventor Centre Report
Mr. G Perianayagam Dr. A Julai
Mr. J Mangwani University Hospitals of Leicester, UK
NO CONFLICT TO DISCLOSE
VA SynthesTM Locking Plates in the use of Foot Reconstructive and Fusion Procedures – A non-inventor
Centre Report
Mr. G Perianayagam
My disclosure is in the Final AOFAS Mobile App.
I have no potential conflicts with this presentation.
Introduction
• Variable Angle (VA) SynthesTM Plates – Relatively new but well recognized system used for foot and ankle fusion and reconstructive procedures.
• Not many non-inventor reports on clinical outcome.
Aim
• Investigate and report our experience of VA SynthesTM Plates in Foot Fusion and reconstructive procedures at the University Hospitals of Leicester, UK
• Outcomes
– Primary : Assess Radiological union rates and time to union – Secondary : Assess complications rates
Methodology • Retrospective Study
• 71 procedures in 48 patients performed by specialist foot and ankle surgeons - June 2012 to Sep 2014
• Data Collection
– Demographics – Medical co-morbidities and Social History – Diabetics / Smoker – Surgical indication and procedure – Types of plate – Union rates and time to union – Complication rates – Infection, Metal work failure and Revision rates
• Data Source – Electronic Theatre log system and clinic letters, Picture Archiving and Communications System (PACS) for the radiological assessment
• A complete radiological union was defined as evident bony trabeculae bridging a minimum of 3 cortices at the site of fusion in two radiographic views.
• Delayed union – Satisfactory union but time to union > 6 months
• Non-union – No satisfactory union > 6 months
• Radiological assessment for union – Single Independent observer
Results
• Age range – (32 -78) years
• Male : Female – 1:2
• Incidence of Diabetics - 17 %
• History of smoking – 8 %
• Surgical Procedures (71) – Fusion (63)
• Single joint fusion (28) • Two joints fusion (7) • Three joints fusion (7)
– Osteotomies (8)
Results Surgical Indication
Degenerative Arthritis
55
Inflammatory Arthritis
5
Post Traumatic
4
Neuropathic 5
Revision Arthrodesis
2
Surgical Procedures 1st TMTJ fusion 11
Lesser toes TMTJ fusion 22
Talonavicular fusion 11
1st MTPJ fusion 3
Calcaneocuboid joint fusion 6
Naviculocuneiform fusion 4
Osteotomies 8
Other joint fusions 8
Results
Primary Outcome • Union rates – 93 %
– Non-union – 5 – Delayed union – 8
• Time to union – Fusion procedures (12-32 weeks) – Osteotomies (6-16 weeks)
Secondary Outcome • Other Complications
– Superficial infection – 2 – Periprosthetic fracture – 1 – Wound blisters – 2
• NO Revision Procedures
• NO Metalwork failure
Conclusion • In our series with the use of VA SynthesTM plates for
foot procedures we experienced – A high union rate – Low number of fixation related complications – No revision procedures
• There was an association between delayed/non-union
and smoking, diabetes and inflammatory Arthritis.
Thank you
No References