Foot Fracture Arthrodesis Performed with Modern Osteosynthesis Plates
Case study: a polytrauma patient with a cuboido-calcaneal dislocation treated through arthrodesis with dedicated plates, by the medical team of Dr. Vlad Gican and Dr. Andrei Ioan Bogdan.
A road accident can change your life in an instant, and it becomes a true test of endurance. But when polytrauma is involved, your health rests in the hands of your doctors.
Dan suffered such an accident earlier this year, sustaining a healed proximal fracture of the second metatarsal, a cuboido-calcaneal dislocation, a dislocation of the cuboid with the base of the third, fourth, and fifth metatarsals, as well as a plantar dislocation of the cuboid.
Rushed to the hospital and advised by his family, he chose a medical team that could guarantee a fast recovery through minimally invasive surgery, using dedicated medical systems, along with a quick rehabilitation. His father had previously suffered a foot fracture and had been treated by the same team.
In his case, the metatarsal bones were affected, so the doctors had to work with extra care and choose a method that would restore his mobility as quickly as possible.
The metatarsals are essential for walking, which is why both the surgery and the recovery process demand close attention. Their role is to act as a support point while walking, since each metatarsal is anchored by three ligaments. Even so, metatarsal fractures are common, and doctors now rely on a wide range of devices to speed up healing. In this case, the team used DePuy Synthes arthrodesis plates that were available at the time.
Dan also sustained a cuboido-calcaneal dislocation, meaning a dislocation of the joints between the tarsal bones. The cuboid bone itself was affected, shifting downward and outward and losing its alignment with the calcaneus.
Dan arrived at the hospital with unbearable pain in the sole of his foot and persistent pain along its lateral side. After the initial consultation, he chose the medical team made up of Dr. Vlad Gican, orthopedic and trauma specialist, and Dr. Andrei Ioan Bogdan, senior orthopedic and trauma physician. The two recommended a cuboido-calcaneal arthrodesis along with a block arthrodesis of the cuboid with the bases of the third through fifth metatarsals, and a graft from the tibial metaphysis. The team performed the surgery using arthrodesis plates specifically designed for these types of fractures.
The implant system consisted of two types of plates, one X-shaped and one with two holes, together with 2.7 mm locking screws.
The angles at which the screws are inserted are critical here, since the way they are fixed determines the locking mechanism, which in turn increases the stability of the implanted device.
The plate adapts easily to the anatomy of the foot, and its arms can be bent with ease for a better fit. These plates are used in osteotomies, arthrodesis procedures, and foot fractures.
Dr. Vlad Gican is an orthopedic and trauma specialist with a subspecialty in sports traumatology and more than 15 years of experience. He practices at several hospitals and private clinics, and can currently be found at Sanador Hospital, the Centrokinetic Recovery Clinic, Medlife Orthopedic Hospital, and Floreasca Emergency Hospital, where his work ranges from surgery to follow-up consultations for patients during their recovery process.
The team also included Dr. Andrei Ioan Bogdan, a senior physician in orthopedics and traumatology with over 15 years of experience as well, specializing in orthopedic surgery, sports traumatology, and foot and ankle surgery. He can currently be found at Medlife Orthopedic Hospital and at the Centrokinetic Recovery Clinic, where he serves as project coordinator.