The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

Klaus Pastl, Wolfgang Schimetta, Klaus Pastl, Wolfgang Schimetta

Abstract

Introduction: The allogeneic bone screw transplant is a new osteosynthesis device making the use of foreign fixation material obsolete for various kinds of indications. Moreover, it is integrated into the recipient bone by natural bone remodeling without harming the surrounding tissue. The aim of this study was to determine the efficacy and safety of the transplant for osteotomy and arthrodesis in hand and foot surgery and to evaluate the clinical importance of the device.

Materials and methods: A single-surgeon case series of 32 patients who had undergone hand or foot surgery with the application of an allogeneic bone screw with an average follow-up time of 1 year is reported. Clinical data were reviewed to evaluate the pain levels and satisfaction of the patients and the frequency and type of complications occurring during the healing process. Routine radiography and computed tomography were reviewed to determine the fusion rate, the ingrowth behavior of the transplant and the possible occurrence of transplant failure.

Results: High patient satisfaction was paired with low postoperative pain levels and a low complication rate. 97% of the patients were free of pain at the timepoint of the second follow-up examination, the mean time of recovery of full mobility was 50.1 ± 26.1 days after surgery. Wound healing disturbance occurred only in two cases. Bony consolidation of the osteotomy or arthrodesis gap as well as osseointegration of the transplant was seen in all cases. No transplant failure or transplant loosening occurred.

Conclusions: The application of the allogeneic bone screw resulted in a 100% fusion rate while the patient burden was low. The transplant is safe and suited for various kinds of osteosynthesis in hand and foot surgery.

Keywords: Allogeneic bone screw; Allograft; Hand and foot surgery; Osteosynthesis; Osteotomy and arthrodesis; Shark Screw® transplant.

Conflict of interest statement

Klaus Pastl is CEO at surgbright GmbH. Wolfgang Schimetta declares no conflict of interest.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Examples of the application of the allogeneic screw in foot surgery. Radiographs showing the incorporation of the transplant used for an MTP I arthrodesis of a patient with type 2 diabetes and peripheral arterial occlusive disease a on the day of surgery, b 20 months after surgery and radiology showing the incorporation of the allogeneic screw used for a Lapidus arthrodesis c 6 weeks and d 12 months after surgery. Transplants are marked by arrows
Fig. 2
Fig. 2
Examples of the application of the allogeneic screw in hand surgery. Postoperative radiographs showing the transplant used for a four-corner fusion a 10 weeks after surgery, b 20 months after surgery. Postoperative radiographs of an IP arthrodesis of the thumb c on the day of surgery, d 12 months after surgery. Transplants are marked by arrows
Fig. 3
Fig. 3
Computed tomography images of a a Lapidus arthrodesis 11 weeks after surgery, b a four-corner fusion 10 weeks after surgery and c a TMT II joint arthrodesis 6 weeks after surgery, all showing bony consolidation of the arthrodesis and the incorporation and partial remodeling of the allogeneic screw

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