A Closer Look At A New Nitinol Compression Staple

A new and innovative memory compression staple system might be the right choice for podiatric surgeons who are looking for strong, convenient and low profile fixation.

The Nitinol Memory Compression Staple is an alternative or complementary fixation to screw or plate fixation, and its unique design offers constant compression at the osteotomy site, according to the manufacturer Vilex. The company notes that tests show the Memory Compression Staple is stronger and has a better pull-out ratio than alternatives.

John Schilero, DPM, FACFAS, has been using nitinol staples for osteotomies and arthrodeses for six years. He notes that other staples, which require expansion of the “cross member,” can disrupt the osteotomy. The Vilex staple offers podiatrists elasticity and compression, adds Dr. Schilero, who is in private practice in Jupiter, Fla.

“Vilex staples offer flexible positioning and can be used on the plantar or tension side of the osteotomy, which is a unique advantage in foot surgery,” explains Dr. Schilero.

In addition to its superiority over other staples, the Memory Compression Staple offers several advantages over plate or screw fixation, according to Dr. Schilero. He notes that not only do staples offer a lower profile, surgery is often more efficient and quicker with staples.

“Staple design also allows the surgeon to visualize the osteotomy site more clearly on plain X-rays and advise the patient more accurately on healing than with more bulky fixation devices like plates that often obscure the area of bone healing,” adds Dr. Schilero.

Peter Blume, DPM, FACFAS, says the Memory Compression Staple offers “significant versatility” as both a primary and secondary form of fixation.

“(The Memory Compression Staple) can be used as an adjunct for arthrodesis procedures such as talonavicular joint arthrodesis, calcaneocuboid joint arthrodesis and hallux interphalangeal joint arthrodesis,” notes Dr. Blume, an Assistant Clinical Professor of Surgery, Anesthesia and Orthopedics and Rehabilitation at Yale University.

“ … It prevents rotation in the frontal and transverse plane. The staple can also be used as a primary form of fixation for similar procedures. It has been extremely beneficial due to its versatility with respect to sizing, ease of use, reproducibility, and the quality and quantity of staples available for each case.”

Dr. Schilero says he initially used the nitinol staples for “simpler procedures such as Akin phalangeal osteotomies” but he has since learned that the staple is an effective tool for a wide range of procedures.

“I was more impressed with its compression, ease of use and low profile in first metatarsal osteotomy bunion surgery, arthrodesis of the first metatarsophalangeal joint, Lisfranc joints and Lapidus-type bunionectomies,” notes Dr. Schilero.

While the staple is versatile, “it does not replace large construct reconstructive fixation techniques for hindfoot or midfoot reconstructive procedures,” adds Dr. Blume. “The example of a Charcot reconstruction of a midfoot, hindfoot or ankle is not the best indication for staple fixation. One should consider beaming, plating or external fixation for patients with osteoporotic bone and osteoarthropathies.”

Additionally, Dr. Blume reminds surgeons that a proper anatomical evaluation of both the patient’s bone quality and stability and their comorbidities is key when utilizing the Vilex Nitinol Memory Compression Staple.

“The Vilex staple affords dynamic compression with low profile and is easy to use,” concludes Dr. Schilero. “This superelastic staple is a useful adjunct to the foot and ankle surgeon, (and) can often facilitate even difficult surgical repairs.”

Ms. Chicano is a freelance writer who lives in Philadelphia.

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