A comparison of union rates and complications between single screw and double screw fixation of sliding calcaneal osteotomy

2019 ◽  
Vol 25 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Bahman SahraNavard ◽  
Parke W. Hudson ◽  
Cesar de Cesar Netto ◽  
Bradley W. Wills ◽  
Ibukunoluwa B. Araoye ◽  
...  
2000 ◽  
Vol 2 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Neal D. Goldman ◽  
Ramsey Alsarraf ◽  
Gary Nishioka ◽  
Wayne F. Larrabee
Keyword(s):  

Hand ◽  
2021 ◽  
pp. 155894472097411
Author(s):  
Luke T. Nicholson ◽  
Kristen M. Sochol ◽  
Ali Azad ◽  
Ram Kiran Alluri ◽  
J. Ryan Hill ◽  
...  

Background: Management of scaphoid nonunions with bone loss varies substantially. Commonly, internal fixation consists of a single headless compression screw. Recently, some authors have reported on the theoretical benefits of dual-screw fixation. We hypothesized that using 2 headless compression screws would impart improved stiffness over a single-screw construct. Methods: Using a cadaveric model, we compared biomechanical characteristics of a single tapered 3.5- to 3.6-mm headless compression screw with 2 tapered 2.5- to 2.8-mm headless compression screws in a scaphoid waist nonunion model. The primary outcome measurement was construct stiffness. Secondary outcome measurements included load at 1 and 2 mm of displacement, load to failure for each specimen, and qualitative assessment of mode of failure. Results: Stiffness during load to failure was not significantly different between single- and double-screw configurations ( P = .8). Load to failure demonstrated no statistically significant difference between single- and double-screw configurations. Using a qualitative assessment, the double-screw construct maintained rotational stability more than the single-screw construct ( P = .029). Conclusions: Single- and double-screw fixation constructs in a cadaveric scaphoid nonunion model demonstrate similar construct stiffness, load to failure, and load to 1- and 2-mm displacement. Modes of failure may differ between constructs and represent an area for further study. The theoretical benefit of dual-screw fixation should be weighed against the morphologic limitations to placing 2 screws in a scaphoid nonunion.


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0047
Author(s):  
Benjamin D. Umbel ◽  
B. Dale Sharpe ◽  
Adam L. Halverson ◽  
Mark A. Prissel

Category: Hindfoot Introduction/Purpose: Surgical correction of Stage 2 posterior tibial tendon dysfunction typically involves a combination of soft tissue and bony corrections, often including a medial displacement calcaneal osteotomy (MDCO). This osteotomy is often fixated utilizing two parallel screws; however, it remains unknown how much correction is lost based on various accepted drilling techniques for common fixation of this osteotomy. Our cadaveric study compares three different surgical drilling techniques, using two parallel cannulated screws for fixation, to best maintain desired translation of the MDCO. Methods: Fifteen above knee, fresh-frozen, matched pair cadaveric specimens (30 limbs) were randomized equally into three groups. Calcanealosteotomies were performed, followed by manual 10 mm medial translation of the tuberosity. Two parallel 2.5mm guide wires were advanced across the osteotomy site under fluoroscopy. The first group involved a ‘staggered’ drilling technique in which one guide wire was over drilled to the osteotomy site with a 4.5mm cannulated drill and then a 7.0 mm cannulated screw was placed across the osteotomy, followed by a second screw in similar fashion. The second, ‘simultaneous’ group consisted of over drilling both guide wires sequentially followed by placement of both screws. The third control group involved simultaneously over drilling only the near cortex, followed by placement of the 2 screws. Following screw fixation, the calcaneal tuberosity was manually translated in a lateral direction. The loss of correction was then marked and measured in millimeters. Results: All thirty cadaveric specimens underwent standard medializing calcaneal displacement osteotomy without significant variation, or complication. Loss of medialization was measured in millimeters following a manual lateral displacing force after the screw fixation of the osteotomy. The ‘simultaneous’ drilling group experienced the greatest loss of medial displacement with the mean loss of correction being 2.6 mm (range 1.37 - 3.48 mm) following manual lateral translation. The ‘staggered’ group showed an average loss of 1.16 mm (range 0.36 - 2.67 mm). The control group, that simply involved drilling of the near cortex, demonstrated the greatest maintenance of medial displacement with a mean loss of only 0.036 mm (range 0.01 - 0.06 mm). Conclusion: Our cadaveric study comparing three different drilling techniques for maintaining the intended correction following MDCO demonstrates that simultaneous over drilling of only the tuberosity near cortex prior to screw fixation was the most resistant to loss of medial displacement; whereas mean loss of correction with simultaneous drilling of both wires to the osteotomy resulted in the greatest loss of correction at an average of 26%.


1995 ◽  
Vol 16 (7) ◽  
pp. 437-439 ◽  
Author(s):  
Mark P. Slovenkai ◽  
Daniel Linehan ◽  
Linda McGrady ◽  
Tae-Hong Lim ◽  
Gerald F. Harris ◽  
...  

Two methods of internal fixation of oblique lesser metatarsal osteotomies were compared biomechanically using fresh-frozen human cadaver bones. Osteotomies were made obliquely through the metatarsal shafts and fixed with either crossed Kirschner wires or a single AO screw using the lag technique. The specimens were then fixed at their proximal end and loaded to failure using an axial torsion material testing system (MTS, Minneapolis, MN). Load displacement curves were obtained and the stiffness of the constructs was determined. Single-screw fixation was found to be significantly stiffer than the crossed wire configuration ( P < .01). Single-screw fixation resulted in a stiffness of 211.2 ± 111.7 N/cm (mean ± SD), while stiffness of the crossed wire configuration averaged 56.9 ± 25.1 N/cm.


2010 ◽  
Vol 3 (4) ◽  
pp. 164-166 ◽  
Author(s):  
William T. DeCarbo ◽  
Gregory C. Berlet ◽  
Christopher F. Hyer ◽  
W. Bret Smith

2021 ◽  
Author(s):  
Haijiao Mao ◽  
Linger Wang ◽  
Jiahui Li

Abstract Proximal crescentic metatarsal osteotomy and distal soft tissue reconstruction have been introduced to correct severe hallux valgus (HV). The intrinsically unstable proximal first crescentic osteotomy depends on enough force fixation for stability. It is necessary to judge the number of fixation’s screw for osteotomy. Fifty two feet from 50 adult patients with severe HV were included in this study. The treatment was proximal crescentic metatarsal osteotomy with a single screw and distal soft tissue reconstruction in Group 1. The fixation with two screws with distal soft tissue reconstruction in Group 2. Clinical and radiological follow-ups were assessed after 4 and 12 months of operation. In Group 1, hallux valgus angle (HVA) was decreased from 46.4 ±3.28 to 19.9 ±4.70 after 12 months of operation. HVA was decreased from 45.1 ±3.45 to19.1 ±4.70 for group 2. For intermetatarsal angle (IMA) in Group 1, it was changed from 18.5 ±1.98 to 9.25 ±1.11 after 12 months of operation. For group 2, it was decreased from 18.3 ±1.81 to 9.53 ±1.70. Meanwhile, the American Orthopedic Foot and Ankle Society (AOFAS) score was improved from 63.1 to 83.9 after 12 months of operation for group1, and was improved from 64.3 to 82.8 for group2. Furthermore, the visual analogue scale (VAS) score was reduced from 4.5±1.01 to 1.7± 0.43 for group 1, and it was reduced from 4.7±0.92 to 1.7±0.55 for group 2 after 12 months of operation. The first metatarsal dorsal elevation was occurred in 4 feet in Group1, and no metatarsal dorsal elevation was occurred in Group 2. There were no significant differences identified among Group1 and Group 2 in terms of VAS and AOFAS scores, and HVA and IMA measurements. However, there is less complication in two-screw fixation for crescentic osteotomy compared to a single screw fixation.


2020 ◽  
Vol 10 (4) ◽  
pp. e20.00408-e20.00408
Author(s):  
Matthew A. Siegel ◽  
Jason Y. Chen ◽  
Maged R. Hanna ◽  
Yasser R. Farid

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110057
Author(s):  
Boren Morgan ◽  
Brian Steginsky ◽  
Mallory Suhling ◽  
Anand Vora

2017 ◽  
Vol 37 (6) ◽  
pp. e342-e346
Author(s):  
Mark Carl Miller ◽  
Christopher N. Redman ◽  
R. Justin Mistovich ◽  
Muturi Muriuki ◽  
Mark J. Sangimino

Sign in / Sign up

Export Citation Format

Share Document