MedShape Inc., Atlanta, reports that during its targeted soft launch period, DynaNail has been successfully implanted in over 100 tibiotalocalcaneal (TTC) fusion procedures. Because the internal nickel titanium (Nitinol) element maintains the target fusion bones in close apposition and under sustained compression, fusions are being observed with the DynaNail TTC Fusion System in high-risk patients, specifically those who require bone allografts. . In many of these patients, a bone allograft was used in combination with DynaNail to fill large bony defects and/or replace a fractured or missing talus
Achieving fusion using an allograft has previously proven challenging, particularly in high-risk patients with degenerative bone conditions or who are immuno-compromised. A 2013 study published in Foot & Ankle International reported a 50% non-union rate in patients who underwent TTC fusion when an allograft was used and no fusions when the graft was used on diabetic patients.
However, a large number of high-risk patients have experienced fusions with DynaNail, as confirmed by CT scan, including many with bulk allografts. Dr. Thomas San Giovanni of the UHZ Sports Medicine Institute in Coral Gables, Fla. has implanted DynaNail in five patients, using a femoral head allograft for three, with successful fusion in each.
“I believe we may be entering a new era within orthopedics where the unique properties of certain materials such as NiTiNOL will be used to our advantage to assist in the healing of bone – complementing both the mechanical and biologic nature of bone healing,” said Dr. San Giovanni. “The DynaNail is the first product of its kind and certainly is on the brink of this technology. I’ve had very good success with the DynaNail in some of the most difficult clinical scenarios where combined arthrodesis of the ankle and subtalar joint was needed. It has become my preferred fixation method when using a nail for TTC fusions. I have been very impressed by its performance and foresee the technology and unique properties of this nail lending itself to many future applications, even for other conditions.”
