Image: The Gorilla lateral column plating system (Photo courtesy of Paragon 28).
A dedicated plating system offers surgeons an aid in the stabilization, fusion, and fixation of the lateral column in people undergoing Charcot reconstruction.
The Paragon 28 (Englewood, CO, USA) Gorilla lateral column plating system is designed to treat a subset of deformities involving mid-tarsal Charcot foot arthropathy reconstruction, in which the plantar subluxation of the cuboid may result in ulceration. The plate and screw construct consists of a dorsal plate and 5.5 mm type II anodized, non-locking, solid plate screw that interfaces with the plate, and which is intended to span from the space between the 4th and 5th metatarsals, through the cuboid, and into the posterior aspect of the calcaneus.
The system contains system specific instrumentation to help facilitate insertion of the 5.5 mm solid plate screw, as well as a unique templating system which not only aids in determining the correct size and location of the plate, but more importantly aids in the creation of a reamed space in a specific location between the 4th and 5th metatarsals. A joint finding paddle designed to center the template allows for equal reaming of the 4th and 5th metatarsals in order to allow room for the 5.5 mm solid plate screw to be placed and achieve optimal screw trajectory.
“Paragon 28 has launched innovative products and instrumentation that help to streamline procedures, allow surgeons flexibility in technique and approach, and facilitate reproducible results benefitting both the surgeon and patient,” said the company in a press announcement. “This addition to the Gorilla plating system family leverages all the benefits of the Gorilla System, including the ability for all of the standard plate holes to accept either 2.7 mm, 3.5 mm, or 4.2 mm locking and non-locking plate screws, as well as a robust assortment of foot and ankle specific instrumentation.”
Charcot foot is characterized by varying degrees of bone and joint disorganization that are secondary to an underlying neuropathy, trauma, and perturbations of bone metabolism. As a result, the bones are weakened enough to fracture, and with continued walking, the foot eventually deforms. The hallmark deformity is midfoot collapse, described as a “rocker-bottom” foot, although it can appear in other joints and with other presentations.