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Clinical Solutions in Practice

Can A New Plate Lead To Better Outcomes With First MPJ Fusion?

June 2010

Are you looking for improved compression for your first metatarsophalangeal (MPJ) fusions? Do your current fusion plate options cause irritation with shoegear in your more active patients?

   A new product may offer some solutions to those dilemmas. The Anchorage MTP Fusion Plate reportedly offers key features that provide reliable compression and reduce potential complications of first MPJ fusion procedures.

   One of the benefits to the Anchorage MTP Fusion Plate is a compression ramp, a screw hole system that facilitates mechanical compression between two corresponding bone segments, according to Memometal (MMI), the manufacturer of the device.

   Mark Hofbauer, DPM, FACFAS, who has used the new fusion plate in 10 first MPJ fusions over the last five months, praises the compression ramp feature.

   “The compression ramp is excellent,” notes Dr. Hofbauer, a Past President of the American Board of Podiatric Surgery. “It allows for compression of the plate without the need for an interfragmentary compression screw.”

   The company says mechanical compression occurs as the surgeon tightens the non-locking screw head into the compression ramp, which offers an elongated screw hole with a graduated depth countersink. As the surgeon tightens the screw, the screw head slides down the compression ramp. The deeper seating of the screw head into the wider portion of the countersink leads to the compression between the plate and the attached bone segments, according to MMI.

   Nathan D. Ivey, DPM, FACFAS, says the design of the Anchorage MTP Fusion Plate enables surgeons to achieve compression across the fusion site.

   “Most plates have eccentric holes … but these plates rely on the surgeon to determine how and if he or she is going to attempt to try and get compression out of the plate,” notes Dr. Ivey, the Vice President of the New Mexico Podiatric Medical Association. “(The Anchorage MTP Fusion Plate) is designed with an offset drill guide that makes the compression work consistently and reliably every time.”

   Dr. Ivey also cites the low profile nature of the Anchorage MTP Fusion Plate.

   “Having a low profile plate allows for less irritation and is less likely to be removed later on,” explains Dr. Ivey, who has used the new fusion plate in six MPJ fusion procedures in recent months. “Many of my patients are female or young healthy patients who are very active. These patients need a low profile plate to get a better fit to the bone and lessen the chances of irritation with shoegear or activity.”

   “It is the best low profile plate out there that incorporates the locking plate technology,” notes Dr. Hofbauer, a Diplomate of the American Board of Podiatric Surgery. “It is very rigid and holds up to weightbearing very well.”

   With the different size configurations and multiple screw locations of the Anchorage MTP Fusion Plate, Dr. Hofbauer says he doesn’t have to bend or curve the plate as much as he has done in the past with other plates. However, Dr. Ivey cautions that the “curvature of the plate may not be perfect and the plates may need to be bent or contoured to fit better.”

   Overall, though, Dr. Ivey says the Anchorage MTP Fusion Plate “is designed for and works great for the first MPJ fusion.”

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