A Closer Look At A Versatile Internal Fixation Device

While there are a variety of fixation options for the lower extremity, one device reportedly provides a unique method for delivering superior compression and stable fixation.

   The IO FiX Intraosseous Device is a proprietary internal fixation device approved for use in arthrodesis, osteotomy and fracture repair in the small bones and joints of the foot and ankle, according to the manufacturer, Extremity Medical. The company notes “the intraosseous advantage” of IO FiX offers a “zero profile,” uniform compression, a reinforced bone bridge and stable fixation while allowing for versatile application in an easy, fast and reproducible device.

   According to Shane Hollawell, DPM, FACFAS, the IO FiX system offers a mix between a standard interfragmentary screw and a locking plate, making it just as versatile as it is unique.

   “To my knowledge, there is no other foot and ankle fixation device available which includes a metallic post and interfrag screw that engage together in a Morse taper configuration,” explains Dr. Hollawell. “This construct provides excellent stability and compression across an osteotomy or joint that is undergoing fusion.”

   Dr. Hollawell has used IO FiX over other methods of fixation in several procedures, including ankle arthrodesis, calcaneal slide osteotomies, talonavicular arthrodesis, Lapidus procedures and calcaneocuboid fusions. In addition, he says the system offers a low to non-existent profile that allows easy access to osteotomy or fusion sites through a smaller incision without compromising stable compression.

   “The 60-degree fixed-angle configurations work exceptionally well in talonavicular and ankle arthrodesis procedures,” notes Dr. Hollawell, who is in practice at the Orthopedic Institute of Central New Jersey.

   Jeffrey Loveland, DPM, agrees that IO FiX’s versatility is a notable advantage in his practice. It is “universal rather than anatomical” as is the case with other fixation devices, says Dr. Loveland, an Associate of the American College of Foot and Ankle Surgeons.

   Dr. Loveland says he commonly uses IO FiX when performing subtalar joint fusions, metatarsal arthrodesis, midfoot and ankle fusions as well as Lapidus procedures and in the talonavicular, calcaneocuboid and metatarsocuneiform joints.

   Both Dr. Loveland and Dr. Hollawell note that after overcoming a slight learning curve, the device is considerably easier to use and less time consuming than other fixation products.

   “Initially, as a result of the minor learning curve, it may take more intraoperative time to place the intraosseous fixation, when compared to standard interfrag screws,” adds Dr. Hollawell. “However, with proper technique and experience, intraosseous fixation placement typically takes less time to implant when compared to standard or locked plate fixation.”

   Drs. Loveland and Hollawell highlight IO FiX’s stable fixation and uniform compression as distinct advantages of the device.

   “The intraosseous fixation provides greater uniform compression than standard lag screw fixation,” explains Dr. Hollawell. “The fixation is rigid and remains more consistent and stable throughout the process of bone healing.”

   Dr. Loveland says there is “less likelihood” that the fixation will have to be removed. While it is sometimes necessary to remove prominent fixation due to hardware irritation of surrounding soft tissues, Dr. Hollawell has not found this to be the case thus far with IO FiX.

   Once surgeons consider the quality of bone they are working with as well as the space available for the procedure, they will most likely find they can do a lot with IO FiX, explains Dr. Loveland.