The Use of Variable Angle Locking SynthesTM Plates in Foot Reconstructive and Fusion Procedures-A Non-Inventor Centre Report

Introduction: The use of locking plates over other conventional methods in fusion and reconstructive foot surgery has become popular. We report our experience with the use of Variable Angle SynthesTM plates in reconstructive and joint fusion procedures. Methods: Seventy one foot reconstructive and fusion procedures in 48 consecutive patients were performed between June 2012 and September 2014. Data was sourced from theatre log, ORMIS, PACS and Dictate IT. An independent observer carried out retrospective analysis of prospectively collected data on patient demographics, indication for surgery, co-morbidities, type of surgical procedure, radiological outcome of union rates and time to union, pre and post-op patient reported outcome scores (MOXFQ score and EQ-5D) and complication rates. Results: The mean age was 59 (range 32-78) years with a 2:1 female predominance. Indication for surgery was degenerative arthritis (55 procedures) in most cases. The overall union rate was 93% with time to union being 6 to 16 weeks in osteotomies and 12 to 32 weeks in fusion procedures. Amongst the 8 delayed unions (3 smokers, 1 Diabetic) and 5 non-unions (2 Diabetics, 2 rheumatoid arthritis on Anti-TNF treatment). There was 1 peri-implant fracture, 2 superficial wound infections, 3 metalwork failures. There was a significant improvement in MOXFQ and EQ-5D scores. Conclusion: This series reports a high union rate, a low number of fixation-related complications, and significant improvement in the patient reported outcome measures with the use of Variable Angle SynthesTM foot plates. There was an association between delayed/non-union and smoking, diabetes and inflammatory Arthritis.