A new plating system offers anterior, posterior, and lateral bone plates to aid surgeons treating tibiotalocalcaneal (TTC) or tibiocalcaneal (TC) arthrodesis.

The Paragon 28 (Englewood, CO, USA) Silverback Straddle Plating System is an off-the-shelf solution that allows primary and revision fusion procedures whenever there is concern related to patient health, compliance, and time to fusion. The system includes 12 unique plates that are available in both flat and contoured options to accommodate varying anatomies; lateral plates are also available in flat versions. All plates have a transitional thickness to ensure they are thickest where subjected to the most stress, and taper proximally and distally to limit soft tissue irritation and potential for a stress riser.

Hole sizing allows for Silverback 4.5 mm and 5.2 mm screws to be used in the tibia and calcaneus, while the talar screw holes allow for Gorilla R3CON 3.5 mm and 4.2 mm screws. A 4.7 mm screw is available for the tibia and calcaneus, designed with a smaller thread height to help reduce insertion torque in the dense bone. The single lead bone threads also result in a decreased pitch differential between locking screw head and bone threads, reducing the amount of insertion torque required to lock the compact screw into the plate in areas of dense bone.

All plates accommodate the Paragon 28 Phantom TTC nail to aid even distribution forces across the construct, and in order to guard against stress shielding during healing. To ensure success, during surgery the Phantom Hindfoot TTC nail should be inserted and compressed in a static mode prior to straddle plate placement. The relatively wider plate design helps evenly distribute force across the construct and guard against stress shielding during healing. All plate screws can be drilled on-axis or off-axis up to 15°.

“The addition of the Paragon 28 Silverback Straddle Plating System offers surgeons an important and unique option for those difficult revision cases,” said orthopedic surgeon Byron Hutchinson, DPM, of CHI Franciscan Health (Burien, WA, USA). “The system is designed to work in concert with the Phantom TTC Nail System. This combined construct is a game changer specifically for hindfoot and ankle Charcot deformities.”

Bone plating is a method of fracture fixation in which one or more metal plates are applied across the fracture and anchored, usually by screws, into the fragments; the broken bones must first be surgically reset into their proper position. The method does have some drawbacks; after initially placing the plate on the break or fracture the bones are compressed together and held under some slight pressure, which helps to speed up the healing process of the bone. 

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