Intraosseous device for arthrodesis in foot and ankle surgery: Review of the literature and biomechanical properties

ARTICLE HIGHLIGHTS

Research background

Numerous fixation devices have been described in literature for foot and ankle arthrodesis. Each of these devices have their own benefits and drawbacks

Research motivation

This review article looked into the use of an intraosseous device IOFIX. Since the entire construct of IOFIX is embedded in the bone, there is less risk of soft tissue irritation and prominence of metalwork.

Research objectives

Outcome scores, union rates, as well as complications associated with the use of IOFIX was looked into.

Research methods

Fully published studies with details of the use of intra osseous devices were included in the study. These were identified by a search through available English literature. Nine related publications were identified and analysed.

Research results

In comparison to plate/screw constructs there were fewer soft tissue complications and issues of metalwork prominence. It also provided adequate compression across the arthrodesis site.

Research conclusions

IOFIX appears to be safe and effective in achieving arthrodesis of the 1^st metatarsophalangeal and talonavicular joints with early rehabilitation. However, cadaveric and biomechanical studies on the use in tarsometatarsal and ankle joint showed some concerns with decreased load to failure and cycles to failure.

Research perspectives

Further clinical trials are required. Prospective and comparative studies with larger sample size and longer follow-up could confirm the effectiveness and limitations of the method.