Biopro Corporation has introduced new instrumentation for the use of peg-in-hole arthrodesis of the digits. Biopro has been at the forefront of new innovation techniques including lesser toe hemi implants, bunion guides, subtalar joint arthroesis implants, tendon passers and a host of other innovative devices. The new TAPAS which stands for Tight, Accurate, Peg Arthrodesis System is the latest in new innovation instrumentation for digital arthrodesis. The company proports the new device provides precise peg-in-hole reproducibility, reduces surgical time and frustrtation, provides straightforward fixation options and avoides expensive destructive implant devices.
The company outlines the procedure by using sizing templates to select an appropriate matching peg former and hole reamer (3.3mm,4.0mm or 4.7mm). The template handle has a peg forming guide on one end and a peg reaming guide on the other. On the proximal phalanx, a template is used to determine the proper placement of the peg to be formed. It should be somewhat dorsal to the center to encompass the dorsal corticle rim of the bone. A k-wire guide is used and the joint surface is “pricked” to provide a starting point for the peg former. There is also an appropriate marking on the template for the peg length.
Once aligned, the peg former is positioned and the rotatry driver will plane a peg from the bone. It is important to not use speeds greater than 1500-2000 rpm to prevent ‘free spinning’ that may damage or fracture the peg.
A hole for the peg is then reamed in the middle phalanx. A template is again used for positioning the hole. The hole is then reamed to size. A k-wire or compression screw can be used for fixation. This device offers an alternative to the traditional peg-in-hole arthrodesis that employs a simple burr system.
