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