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Related Concept Videos

Wood Fasteners01:18

Wood Fasteners

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In wood construction, fasteners are essential for securing components together, with the connection strength largely dependent on the direct bearing between members. Various types of fasteners are employed, each suited to specific applications and structural requirements.
Nails are the most common fasteners, consisting of sharp-pointed metal pins that are driven into wood using a hammer or a mechanical nail gun. They come in a variety of diameters, heads, and lengths. Nailing techniques include...
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Screw versus staple fixation for Akin osteotomy.

M A Fazal1, H Simon1, J A Bacarese-Hamilton1

  • 1Royal Free Hospitals London NHS Foundation Trust.

Annals of the Royal College of Surgeons of England
|July 29, 2021
PubMed
Summary

For Akin osteotomies, staple fixation offers satisfactory outcomes comparable to screw fixation but at a significantly lower cost. Staples are a cost-effective alternative for hallux valgus surgery.

Keywords:
AkinHallux valgusOsteotomyScrewStaple

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Surgical Outcomes Research

Background:

  • Akin osteotomies are frequently stabilized using screws or staples.
  • Hardware-related complications can occur with both fixation methods.
  • Comparing outcomes and costs of screw versus staple fixation is crucial for clinical decision-making.

Purpose of the Study:

  • To compare the clinical and radiological outcomes of headless compression screws versus staples for Akin osteotomies.
  • To evaluate implant-related complications, revision rates, and costs associated with each fixation method.
  • To determine the cost-effectiveness of staple fixation as an alternative to screw fixation in hallux valgus surgery.

Main Methods:

  • A retrospective evaluation of 74 Akin osteotomies performed with first metatarsal osteotomy for hallux valgus.
  • Fixation was achieved using headless compression screws (39 cases) or staples (35 cases).
  • Outcomes assessed included implant complications, need for hardware removal, revision surgery, non-union rates, and cost analysis. Radiological parameters like hallux valgus interphalangeal (HI) angle and proximal phalanx length were measured.

Main Results:

  • All cases achieved 100% union with no fixation failures or need for revision surgery.
  • Screw fixation showed significantly higher radiological prominence (p=0.02) but no significant difference in soft-tissue irritation or implant removal rates.
  • No significant differences were observed in HI angle improvement or proximal phalanx shortening between the groups. Staple fixation was substantially more cost-effective (£1,925) compared to screw fixation (£4,290).

Conclusions:

  • Both staple and screw fixation provide reproducible and satisfactory outcomes for Akin osteotomies.
  • Screw fixation is associated with a higher cost without demonstrable clinical advantages over staples.
  • Staple fixation emerges as a cost-effective alternative for Akin osteotomies in hallux valgus correction.