20/12/2006
AO Technical Commission Approved

Locking X Plate

Post traumatic arthritis, rheumatoid arthritis, and neurological disorders can cause severe deformities such as cavus foot, equinovarus, telipes, and planovalgus. Treatment of these deformities by an osteotomy or a fusion of one or several joints bears the risk of screw breakage due to high shear forces. Other disadvantages are long healing and rehabilitation time. Metatarsophalangeal arthroplasty may leave a large defect if it fails.

The Locking X-Plate 2.7 was developed to treat these deformities of the foot by a rigid fixation construct with high primary stability. It is a stand alone implant in osteotomies and serves as a neutralization plate in arthrodesis of foot joints in combination with one or two compression screws. Primary indications are first metatarso cuneiform fusions, proximal first metatarsal osteotomies (crescentic, open wedge, Mann, Ludloff, and proximal Chevron) and first metatarso phalangeal fusions.

 

The Locking X-Plate 2.7 is a geometric, low profile and easy to bend implant. This enables further usage for calcaneal osteotomies (Evans and Dwyer), metatarso nonunion fractures, supramalleolar osteotomies, and diabetic foot reconstruction.

Screw angulation prevents collision of the screws. The two dorsal screws are more angulated. The osteotomy can be crossed with a locking head screw when fixing a proximal metatarsal osteotomy providing high stability according to the locked internal fixator principle.

The X-Plate is fully compatible with the Compact Foot Set 2.7.


Now an additional size is available, extra small, with a foot print of 16 x 8 mm. Overall, there are four different sizes of the plates, according to the anatomical region and to the size of the foot: extra small, small, medium, and large. It is also likely to be used in countries where the ethnic anatomy is rather smaller than in other parts of the world.

Case 1: 62-year-old female

One year after modified Lapidus operation with screws in the right foot. Now new treatment with an X-Plate (medium size) in the left foot.

Compared to screw osteosynthesis in the right foot, full weight bearing was possible after 6 weeks instead of 12 (see Fig 4)


Case 2: 16-year-old male

Proximal first metatarsal growth-plate injury resulting in haluxvalgus. Arthrosis of first tarsometatarsal and second metatarsal hammer toe. Pain during activities and in general shoe wear.

Case provided by Carl Hasselman, Pennsylvania, USA

First MTP fusion and modified McBride with a distal softtissue release and second metatarsophalangeal (MTP) capsulotomy. A mini tight rope was used to hold and reduce the alignment of the first metatarsal. The X-plate was used to hold rigid fixation of the fusion. A K-wire was used for the second MTP capsulotomy.

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