Plating System May Provide Enhanced Fixation For Hallux Valgus Surgery

A unique plating system may offer consistent plantar compression and various options for screw placement during hallux valgus surgery.

The Omni Plating System works with the PlantarFiX™ Post, which produces a broader surface area of compression across the joint to assist with fusion regardless of bone quality, according to the manufacturer Extremity Medical. The company notes that along with the plate’s stability, the compression eliminates the risk of plantar gapping that can occur with other dorsal plates.

Extremity Medical says the PlantarFiX Post acts as a metal cortex and that screw/post compression is independent of bone quality. The Omni Plating System also offers versatile placement with the post working in all locking holes in every Omni plate. The company adds that the two-part design allows the distal hole to rotate 360 degrees. The Omni Plating System is available with 2.8 and 3.5 mm variable angle locking and non-locking screws as well as 3.5 mm compression screws.

Michael Black, DPM, FACFAS, has used the Omni Plating System to correct hallux valgus with tarsometatarsal arthrodesis. He has also used the plating system for Charcot foot reconstruction involving reduction and for primary arthrodesis of Lisfranc dislocations. He notes the Omni Plating System’s unique fixation construct allows the surgeon to place a lag screw for compression through a locking post that is locked to the plate at 90 degrees.

“This allows for unsurpassed compression and rigidity of fixation,” notes Dr. Black, who is in private practice at Orthopedic Associates of Cape Coral in Cape Coral, Fla.  

Khawar Malik, DPM, has been using the Omni Plating System since last year for severe bunion deformity correction either at the first metatarsophalangeal joint (MPJ) or the first tarsometatarsal joint. He notes the Omni plates are low profile in different shapes and sizes. Other systems do not offer the Omni Plating System’s guided posts for lag screw placement or options for staple compression through the plate, points out Dr. Malik, who is in private practice at Podiatry Associates of Indiana.

Jeffrey S. Stevens, DPM, FACFAS, most frequently uses the Omni Plating System for Lapidus procedures or first MPJ arthrodesis. He says the PlantarFiX Post provides better and controlled compression across the fusion site, comparing it to using a lag screw and nut, which avoids the risk of a screw losing purchase. The plates are thin and perfectly contoured for any midfoot or forefoot application, says Dr. Stevens, who is in private practice at Indy South Foot and Ankle in Indianapolis.   

Dr. Black notes the Omni Plating System’s compression can be especially advantageous in patients with poor bone quality such as the geriatric population and patients with diabetes, neuropathy and a variety of metabolic bone diseases.  

“Increased rigidity and compression are paramount to achieving successful and timely healing of the arthrodesis site. They could also offer decreased failure rates and a potentially earlier return to weightbearing activities,” says Dr. Black.

Dr. Black adds that placing the lag screw through the locking post does restrict the trajectory and orientation of the lag screw across the arthrodesis site. He says this can be an issue with retained hardware from prior surgeries or advanced deformity. However, citing the system’s versatility, Dr. Black notes if the trajectory of the lag screw does not allow it to pass through the locking post, the surgeon can simply default to using locking or non-locking screws to secure the plate to bone as one would do with traditional fixation methods.

In the last six weeks of using the Omni Plating System, Dr. Black says patients have demonstrated “excellent healing” and adds that he has not had any instances of infection, hypersensitivity reaction, hardware pain or other hardware-related complications. Postoperatively, Dr. Stevens says the purchase strength of the compression allows his patients to ambulate in a walking boot sooner with less swelling.