Uni-clip staples combined with titanium alloy Bold screws for treatment of tarsometatarsal joint in-juries

Abstract

Objective To investigate the clinical effects of uni-clip staples combined with titanium alloy Bold screws for the treatment of tarsometatarsal joint injuries. Methods From June 2006 to De-cember 2007, 14 cases of tarsometatarsal joint injuries were treated with a combination of uni-clip staples and Bold screws, including 4 simple dislocations and 10 fracture-dislocations. According to Myerson's classifica-tion, 2 cases were of type A, 8 type B (1 type B1 and 7 type B2), and 4 type C. Injuries involved only medial column in 2 cases, middle column in 3, medial and middle columns in 2, middle and lateral columns in 5, and 3 columns in 2. In addition, 2 were combined with cuboid fractures. Results All the wounds healed primarily. At 4 weeks all the patients began functional exercise after removal of the plaster casts. At 12-16 weeks all the patients began to walk with partial weight loading after removal of the implants, and at 22 weeks they started to walk with full weight loading. The follow-ups lasted for an average of 8.7 (4 to 14) months. The American Orthopaedic Foot & Ankle Society (AOFAS) score averaged 83.7 (75 to 91). Conclusions As the Uni-clip staple can fix tarsometatarsal dislocations without damaging the articular surface, it can reduce the occurrence of osteoarthritis. More reliable than Kirschner wire, it is capable of elastic fixation of the lateral columns. It can also treat cuboid fractures with satisfactory results. In addition, Bold screws may allow automatic reduction and stable fixation of fractures in small wounds by compressive forces. It also protects the dorsal cortex of the metatarsal bone. A combined use of the two can lead to satisfactory results in the treatment of tarsometatarsal joint injuries. Key words: Foot ioints; Foot iniuries; Internal fixator