CME OnDemand: 2022 AOFAS Annual Meeting-Increased Complication and Hardware Removal Rates Associated with Headed Screws in Subtalar and Ankle Arthrodeses Poster

Increased Complication and Hardware Removal Rates Associated with Headed Screws in Subtalar and Ankle Arthrodeses Poster

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This study aimed to compare the clinical and patient-reported outcomes between headless, variable-pitched screws and headed screws in subtalar (ST) or ankle arthrodesis surgeries. A retrospective review was conducted on 120 patients who underwent arthrodesis with a single foot and ankle surgeon. The patients were divided into two groups based on the type of screw used: headless screws (66 patients) and headed screws (57 patients).<br /><br />The results showed that there were no significant differences in demographics, medical history, follow-up duration, or postoperative patient-reported outcome measures (PROMs) between the two groups. However, there were significant differences in the rates of certain complications and reoperations. The headless screw group had a lower rate of nonunion (18.2% vs. 35.1%), reoperation (12.1% vs. 33.3%), and hardware removal (4.5% vs. 31.6%) compared to the headed screw group. The number of screw issues (e.g., broken, displacement, impingement) with headed screws also showed a trend towards significance.<br /><br />Of the five patients who underwent revision arthrodeses for nonunion, headed screws were removed in each case. These findings suggest that using headless screws in open subtalar and ankle arthrodesis surgeries may lead to fewer postoperative complications and reoperations for hardware removal compared to the use of headed screws. This can potentially reduce the economic and surgical burden on patients and the healthcare system.<br /><br />Further studies are needed to compare the outcomes of headless and headed screws in procedures other than subtalar and ankle arthrodesis, as well as to compare the outcomes of different manufacturers of these screws.

Asset Subtitle

Evan Bailey, Caroline P. Hoch, Jonathan B. Goodloe, MD, Daniel J. Scott, MD, MBA, Christopher E. Gross, MD

Keywords

clinical outcomes

patient-reported outcomes

headless screws

variable-pitched screws

headed screws

subtalar arthrodesis

ankle arthrodesis

retrospective review

complications

reoperations