The Use of Nitinol Continuous Compression Implants in Orthopaedic Trauma

Background

Continuous compression implants (CCIs) can provide continuous compression across a fracture site. They are mainly used in foot/ankle surgery, with very limited descriptions in the literature of their potential for trauma. The aim of this study was to describe the use and associated outcomes of CCIs in modern day trauma practice.

Methods

This was a single-centred case series with a retrospective analysis of a prospectively maintained database of any patients who were treated with a CCI across 4 years. The primary outcome was to determine the mode of the CCIs and secondary outcomes were unplanned returns to theatre.

Results

60 patients were eligible with a mean age of 44.2 and 122 CCIs were used. 51 patients were treated for acute fractures, 9 were treated for non-unions, and 27 patients had open injuries. 42 of the 122 CCIs were used as definitive fixation (midfoot dislocations, an iliac wing fixation and isolated medial malleolus fixation), and the rest as adjuncts for fixation; of this remainder, 39 were used in reduction mode, 38 for fixation of key fragments, and 3 for compression. Ten patients returned to theatre, two for metalwork failure, two for infection and 6 for non-unions—three were acute fractures and three originally non-unions.

Conclusion

This paper demonstrates a novel technique for the use of CCIs in UK trauma practice as either definitive fixations or in three different modes as adjuncts to fixation. They do not replace tradition implants but do have equivalent rates of complications. They may be a useful tool in the arsenal for trauma surgeons.