Rearfoot Fusion Plating System Provides Maximum Strength – Surgical Techniques


Image: The Silverback Straddle plating system (Photo courtesy of Paragon 28)

A new plate system offers anterior, posterior and lateral bone plates to help surgeons treat tibiotalocalcaneal (TTC) or tibiocalcaneal (TC) arthrodesis.

The Silverback Straddle Paragon 28 Plating System (Englewood, CO, USA) is a plug-and-play solution that allows for primary fusion and revision procedures whenever there are patient health concerns. , observance and time of fusion. The system includes 12 unique plates which are available in flat and contoured options to accommodate different anatomies; side plates are also available in flat versions. All plates have a transition thickness to ensure they are thickest where they are under the most stress, and narrow proximally and distally to limit soft tissue irritation and potential for increased stress.

The hole sizes allow the use of 4.5mm and 5.2mm Silverback screws in the tibia and calcaneus, while the talus screw holes allow the use of 3.5mm Gorilla R3CON screws and 4.2 mm. A 4.7mm screw is available for the tibia and calcaneus, designed with a smaller thread height to help reduce insertion torque in dense bone. Single-pitch bone threads also result in a decrease in the pitch differential between the locking screw head and the bone threads, reducing the insertion torque required to lock the compact screw into the plate in areas of dense bone. .

All plates accommodate the Paragon 28 Phantom TTC nail to promote even distribution of forces throughout the construction and to guard against stress protection during healing. To ensure success, during surgery the Phantom Hindfoot TTC Nail should be inserted and compressed in a static mode prior to placement of the Overlap Plate. The relatively wider plate design helps distribute the force evenly over the construction and guard against stress during healing. All plate screws can be drilled on-axis or off-axis up to 15 °.

“The addition of the Paragon 28 Silverback Straddle Plating System offers surgeons an important and unique option for difficult revision cases,” said orthopedic surgeon Byron Hutchinson, DPM, of CHI Franciscan Health (Burien, WA, USA ). “The system is designed to work in conjunction with the Phantom TTC nail system. This combined construction is a game-changer specifically for Charcot’s deformities in the rearfoot and ankle.

Bone veneer is a method of fracture fixation in which one or more metal plates are applied across the fracture and anchored, usually by screws, into the fragments; broken bones must first be surgically replaced in their proper position. The method has a few drawbacks; After initially placing the plaque over the break or fracture, the bones are compressed together and held under slight pressure, which helps speed up the healing process of the bone.

Related links:
Paragon 28
CHI Franciscan Health

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