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William Fishco, DPM, FACFAS, offers a few intra-operative pearls with his approach to the opening base wedge osteotomy.

 

Dr. Fishco is board-certified in foot surgery and reconstructive rearfoot and ankle surgery by the American Board of Podiatric Surgery. He is in private practice in Phoenix. Dr. Fishco is also a faculty member of the Podiatry Institute.

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Presented by William Fishco, DPM, FACFAS
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Comments

What particular type of plate and bone subs is used in this video?

The plate is called the BOW plate by Wright Medical (these are DARCO which was purchased by Wright). Ascension Orthopedics has a similar plate. The back fill bone graft material used was DBX, which is s demineralized bone matrix. I will generally use the "bunion eminence" and if I need more bone, then I will use a product such as Grafton or DBX. It really does not matter what product you use. I personally feel the bone would fill in nicely even without back filling.

 

William D. Fishco, DPM

The plate used in the video is made by Wright Medical. The bone filler is DBX which is made by Synthes. My personal opinion is that it really does not matter which bone filler that you use. It would probably heal well without a filler. I typically use the bunion eminence which is typically what you would need. If there is not much of a bunion eminence such as in a revisional bunionectomy where the head has already been shaved, then you will need something like Grafton, DBX, freeze dried bone chips, etc.

 

There are other vendors that have opening wedge plates such as Arthrex, Ascension Orthopedics, and others. I do like the locking plates but they are bulkier than the Arthrex plate, which is not locking. I have had a patient break an Arthrex plate before, so I am a little cautious about using that plate in a larger patient or in one whom I think may be non-compliant with non-weightbearing.

 

William D. Fishco, DPM, FACFAS

Very informative but I wish they would mention the post-op care for this condition.