Background: Screw head prominence in the heel following fixation for calcaneal osteotomy or subtalar arthrodesis has resulted in high rates of symptomatic hardware and screw removal. A cost analysis was performed to determine the financial implications of screw removal. Furthermore, we compared the rate of nonunion following fixation.
Methods: codes were used to identify all patients who had a subtalar arthrodesis or calcaneal osteotomy (with screw fixation) performed between 2010 and 2016. The cohort was divided into 2 groups: 7.0-mm headless screw or 6.7-mm headed screw. The primary outcome measure was the rate of symptomatic screw removal. Secondary outcomes included the rate of nonunion. The expense associated with symptomatic hardware removal was determined by cost analysis.
Results: Seventy-six patients underwent headless screw fixation, and 2 patients (2.6%) required screw removal. Fifty-four patients underwent headed screw fixation and 12 patients (22.2%) required screw removal. Symptomatic hardware removal was performed more frequently in the headed screw group ( < .001). There was no difference in the rate of nonunion after subtalar arthrodesis between the 2 groups ( = .363). The calcaneal osteotomy united in 100% of patients. There was a $51 755 cost savings per 100 cases using headless screw fixation.
Conclusion: The rate of symptomatic screw removal was lower with headless screw fixation. The calcaneal osteotomy healed in 100% of patients, and there was no difference in the rate of subtalar nonunion between the 2 groups. Cost analysis demonstrated a significant benefit when the expense of hardware removal was considered.
Level Of Evidence: Level III, retrospective cohort study.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702910 | PMC |
| http://dx.doi.org/10.1177/2473011420977864 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Osseointegration and fixation opportunities of sacroiliac instrumentation: a preclinical evaluation in a large animal model.
J Spine Surg
December 2024
Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, AUS.
Background: Implant fixation is often the cornerstone of musculoskeletal surgical procedures performed to provide bony fixation and/or fusion. The aim of this study was to evaluate how different design features and manufacturing methods influence implant osseointegration and mechanical properties associated with fixation in a standardized model in cancellous bone of adult sheep.
Methods: We evaluated the performance of three titanium alloy implants: (A) iFuse-TORQ implant; (B) Fenestrated Sacroiliac Device; and (C) Standard Cancellous Bone Screw in the cancellous bone of the distal femur and proximal tibia in 8 sheep.
Association between final local kyphosis angle and residual back pain in traumatic vertebral fractures at the thoracolumbar junction with posterior stabilization using percutaneous pedicle screws.
J Spine Surg
December 2024
Department of Orthopedic Surgery, Toyama Prefectural Central Hospital, Toyama City, Japan.
Background: There is no consensus on the association between final local kyphosis and residual back pain (RBP) after traumatic vertebral fracture. The aim of this study was to investigate whether there is an association between the final local kyphosis angle and RBP in patients with traumatic vertebral fractures at the thoracolumbar junction who underwent single posterior surgery with percutaneous pedicle screws and implant removal after fracture healing. A second goal was to determine the optimal cut-off value for the final local kyphosis angle with and without RBP.
View Article and Find Full Text PDFMini Fragment and Small Fragment Screws are Comparable in Acute Syndesmotic Injury.
J Foot Ankle Surg
January 2025
Trauma Unit, Department of Surgery, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. Electronic address:
Ankle fractures are often accompanied by syndesmotic injuries, contributing to instability and potential long term complications. Syndesmotic injuries are traditionally fixed with either small fragment (3.5-mm diameter) or large fragment (4.
View Article and Find Full Text PDFRisk Factors and Impact of Intra-Articular Scarring After Open Reduction and Internal Fixation in Mandibular Condylar Head Fractures-A Prospective Analysis.
J Clin Med
January 2025
Department of Oral and Maxillofacial Surgery, University of Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
During the routine removal of osteosynthesis materials after surgical treatment (ORIF) of condylar head fractures (CHFs), as performed at our clinic, localised and sometimes pronounced intra-articular scarring were observed quite regularly. This prospective study therefore investigates the causes of intra-articular scarring and its impact on functionality after surgical treatment (ORIF) of condylar head fractures (CHFs). Moreover, 80/98 patients with 96/114 CHFs (ORIF between 2014 and 2024) were evaluated when performing hardware removal.
View Article and Find Full Text PDFStress Analysis in Conversion Total Hip Arthroplasty: A Finite Element Analysis on Stem Length and Distal Screw Hole.
J Clin Med
December 2024
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba 305-8575, Ibaraki, Japan.
Proximal femoral fractures are particularly common in older adults, and cases requiring conversion to total hip arthroplasty may arise because of treatment failure or osteoarthritis. Fractures around the distal screw removal holes can be problematic. This study aimed to analyze the relationship between stem length and femoral stress distribution to determine the optimal stem length.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!