Intramedullary medial column support with the Midfoot Fusion Bolt (MFB) is not sufficient for osseous healing of arthrodesis in neuroosteoarthropathic feet

Eschler, Anica; Wussow, Annekatrin; Ulmar, Benjamin; Mittlmeier, Thomas; Gradl, Georg

doi:10.1016/j.injury.2013.10.037

Cited by 48 publications

(28 citation statements)

References 30 publications

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“…Even with a slight dislocation of the MFB in the medial and/or lateral column, no signification loss of correction was observed. Addressing single foot columns with the MFB as a stand-alone implant leads to a high rate of complications and recurrent instability [37]. The initial instruction manual of the MFB system stated that a ''stand alone'' use of MFB is not recommended.…”

Section: Discussionmentioning

confidence: 99%

“…without any further implants of any kind (MFB or other). So, the use of two or three MFB as recommended in the manuscript would not be ''stand alone'' [37].…”

Section: Discussionmentioning

confidence: 99%

“…With two or even three MFBs diverging along different axis in the foot this problem is overcome [37]. Alternatively, other implants than a second or third MFB like plates and screws may be added to achieve a stable ''superconstruct'' to avoid implant failure and recurrent deformity under the conditions of manifest CN.…”

Section: Discussionmentioning

confidence: 99%

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Intramedullary fixation in severe Charcot osteo-neuroarthropathy with foot deformity results in adequate correction without loss of correction – Results from a multi-centre study

Richter¹,

Mittlmeier

Rammelt

et al. 2015

Foot and Ankle Surgery

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Realignment and fixation with MFB in severe CN result in adequate correction with minimal loss of correction in the observed clinical course. The non-union rate was lower than previously reported. Stable fixation with MFB is a valuable treatment option for CN with minimal loss of correction and high union rates. The use of a minimum of two bolts is recommended to avoid recurrent deformity. Clinical Trials.gov: NCT01770639.

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Section: Discussionmentioning

confidence: 99%

“…without any further implants of any kind (MFB or other). So, the use of two or three MFB as recommended in the manuscript would not be ''stand alone'' [37].…”

Section: Discussionmentioning

confidence: 99%

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Intramedullary fixation in severe Charcot osteo-neuroarthropathy with foot deformity results in adequate correction without loss of correction – Results from a multi-centre study

Richter¹,

Mittlmeier

Rammelt

et al. 2015

Foot and Ankle Surgery

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“…Three groups have reported a total of 19 feet in 19 patients using this implant at a mean follow-up of 18.5, 27 and 24 months, respectively. 4,14,26 Wiewiorski et al 4 reported eight feet with a mean Meary angle pre-operatively of 15º ,compared with 26º in our series, with four having concomitant ulceration at the time of surgery, compared with nine of ten in our series. 4 Cullen et al 14 However, in all feet, including our series, no incidence of implant bending or breakage was encountered.…”

Section: Discussionmentioning

confidence: 39%

“…4 Cullen et al 14 However, in all feet, including our series, no incidence of implant bending or breakage was encountered. 4,14,26 We used the Midfoot Fusion Bolt to enable intramedullary fusion with a lower implant failure rate than 6% as reported by Grant et al with fixation using a cannulated screw. 27 The bolt is specifically designed for midfoot fusion in patients with CN.…”

Section: Discussionmentioning

confidence: 99%

The medial column Synthes Midfoot Fusion Bolt is associated with unacceptable rates of failure in corrective fusion for Charcot deformity

Butt

Hester

Bilal

et al. 2015

The Bone & Joint Journal

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Charcot neuro-osteoarthropathy (CN) of the midfoot presents a major reconstructive challenge for the foot and ankle surgeon. The Synthes 6 mm Midfoot Fusion Bolt is both designed and recommended for patients who have a deformity of the medial column of the foot due to CN. We present the results from the first nine patients (ten feet) on which we attempted to perform fusion of the medial column using this bolt. Six feet had concurrent hindfoot fusion using a retrograde nail. Satisfactory correction of deformity of the medial column was achieved in all patients. The mean correction of calcaneal pitch was from 6° (-15° to +18°) pre-operatively to 16° (7° to 23°) post-operatively; the mean Meary angle from 26° (3° to 46°) to 1° (1° to 2°); and the mean talometatarsal angle on dorsoplantar radiographs from 27° (1° to 48°) to 1° (1° to 3°). However, in all but two feet, at least one joint failed to fuse. The bolt migrated in six feet, all of which showed progressive radiographic osteolysis, which was considered to indicate loosening. Four of these feet have undergone a revision procedure, with good radiological evidence of fusion. The medial column bolt provided satisfactory correction of the deformity but failed to provide adequate fixation for fusion in CN deformities in the foot. In its present form, we cannot recommend the routine use of this bolt.

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Surgical Reconstruction of the Charcot Foot

Liu

Raspovic

Wukich

2020

The Foot in Diabetes

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Intramedullary medial column support with the Midfoot Fusion Bolt (MFB) is not sufficient for osseous healing of arthrodesis in neuroosteoarthropathic feet

Cited by 48 publications

References 30 publications

Intramedullary fixation in severe Charcot osteo-neuroarthropathy with foot deformity results in adequate correction without loss of correction – Results from a multi-centre study

Intramedullary fixation in severe Charcot osteo-neuroarthropathy with foot deformity results in adequate correction without loss of correction – Results from a multi-centre study

The medial column Synthes Midfoot Fusion Bolt is associated with unacceptable rates of failure in corrective fusion for Charcot deformity

Surgical Reconstruction of the Charcot Foot

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