BIOFOAM Wedge System SURGICAL TECHNIQUE
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Wedge System

BIOFOAM® Wedge System SURGICAL TECHNIQUE Surgical Technique as described by: Robert Anderson, MD OrthoCarolina Charlotte, NC Thomas Lee, MD Orthopaedic Foot and Ankle Center Columbus, OH

BIOFOAM® Wedge System Design Rationale BIOFOAM® Evans Wedge System Surgical Technique BIOFOAM® Cotton Wedge System Surgical Technique BIOFOAM® Wedge System Sizing Proper surgical procedures and techniques are the responsibility of the medical professional. The following guidelines are furnished for information purposes only. Each surgeon must evaluate the appropriateness of the procedures based on his or her personal medical training and experience. Prior to use of the system, the surgeon should refer to the product package insert for complete warnings, precautions, indications,...

Chapter Design Title Rationale BIOFOAM® CANCELLOUS TITANIUM™ Technology The revolutionary BIOFOAM® CANCELLOUS TITANIUM™ technology mimics the strength and flexibility of true cancellous bone by providing a number of unique features: • Extensive ingrowth without the risk of an immune response from traditional allografts. • With a fully interconnected porosity of up to 70%, the titanium matrix provides an ideal environment for optimum bone ingrowth and incorporation. | FIGURE 1A AND 1B • Compressive strength that is between that of cortical and cancellous bone, thus minimizing deformation...

BIOFOAM® Wedge System The BIOFOAM® Wedge System provides sterile, pre-sized implants for use in a variety of procedures of the foot. With two unique shapes, the system is described for specific use in an Evans Procedure for Lateral Column Lengthening, and in a Cotton Procedure for Plantar Flexion Opening Wedge Osteotomies of the Medial Cuneiform. | FIGURES 3A AND 3B Although, the general techniques can be applied to other opening wedge osteotomies of the foot. FIGURE 3A | Lateral Column Lengthening with the BIOFOAM® Evans Wedge FIGURE 3B | Medial Cuneiform Opening Wedge Osteotomy with the...

Chapter BIOFOAM® Title Wedge System Evans Surgical Technique BIOFOAM® Evans Wedge An incision is made just below the sinus tarsi, extending laterally approximately 3cm proximal to the calcaneal-cuboid joint. | FIGURE 5 The peroneal tendons and sural nerves are carefully retracted, and the calcanealcuboid joint is exposed. | FIGURE 6 Beginning 10-15mm proximal to the calcaneal-cuboid joint, the osteotomy is made with an oscillating saw, and the cut is finished with an osteotome. | FIGURE 7 A pin-style distractor, with pin placement on either side of the osteotomy, is installed to provide...

Once the correct footprint and thickness of the wedge are determined, the trial’s color and size is noted and the trial is removed. Refer to TABLE 1 for trial sizing. TABLE 1 | BIOFOAM® EVANS TRIAL SIZING IMPLANT PART NO. 46S51808 IMPLANT LABEL AND TRIAL COLOR FOOTPRINT (WIDTH X DEPTH IN MM) Prior to inserting the wedge, the center hole of the BIOFOAM® Wedge may be filled with bone grafting material as per surgeon preference. Alternatively, after insertion, a viscous biologic may be inserted through the insertion hole. BIOFOAM® Evans Wedge Surgical Technique

Insert the BIOFOAM® Wedge which corresponds to the trial that provides the desired correction. | FIGURE 11 Seat implant with impactor until flush with bone. | FIGURE 12 Final correction is checked fluroscopically. Loosen and remove pin-style distractor, ensuring that there is good bone contact with the wedge in both planes. CLAW® Plate Insertion Installation of ancillary fixation is required when using BIOFOAM® Wedges. The technique below describes utilizing the CHARLOTTE® CLAW® Plate for fixation, as the plate allows compression to optimally secure the wedge. | FIGURE 13 Refer to the CLAW®...

BIOFOAM® Cotton Wedge System Surgical Technique BIOFOAM® Cotton Wedge The BIOFOAM® Cotton Wedges are available in two footprint depths – 16mm and 20mm – and three corrective thicknesses – 4.5mm, 5.5mm, and 6.5mm. | FIGURE 18 AND TABLE 2 The keystone shape of the implant accommodates the unique geometry of the medial cuneiform. The implant’s central auxiliary hole may be used for the addition of biologics or autograft chips according to surgeon preference if so desired. TABLE 2 | BIOFOAM® COTTON WEDGE SIZING PART NO. The following surgical technique addresses the use of the BIOFOAM® Cotton...

The appropriate size wedge is determined by inserting the colored trials into the ostetomy site. | FIGURE 16 Correction is verified under lateral fluoroscopy by assessing the declination of the first metatarsal plantarly. There are three corrective thicknesses of BIOFOAM® Cotton wedges – 4.5mm, 5.5mm, and 6.5mm – to achieve optimal plantar flexion of the first ray. Additionally, the depth of the wedge should be analyzed under fluoroscopy to ensure an interference fit and minimal protuberance of the implant along the dorsal surface. The BIOFOAM® Cotton wedges have two depths – 16mm and 20mm...

BIOFOAM® Wedge System Sizing BIOFOAM® EVANS WEDGE SIZING FOOTPRINT OPTIONS THICKNESS OPTIONS BIOFOAM® COTTON WEDGE SIZING PLANTAR WIDTH (MM) FOOTPRINT OPTIONS BIOFOAM® Wedge System Sizing THICKNESS OPTIONS

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