Dynamic Compression Staples: Flash in the Pan or Wave of the Future?

by Vince Vacketta, DPM

Nitinol dynamic compression staples (DCS) continue to rise in popularity and new research is highlighting their benefits. The first gold star for dynamic compression staples (DCS) comes from a recent bench study evaluating four different fixation constructs for 1st TMT fusion. Both pre and post cyclic loading, the authors found the use a single, four-legged DCS alongside a static screw provided superior joint contact area and force, as well as reduced plantar gapping of the 1st TMT, compared to the other constructs tested. The other constructs evaluated included a single DCS group, a bi planar DCS group, and a compression screw + plate group. 

In a recent clinical retrospective review, the use of DCS for midfoot and Chopart fusion was evaluated. The primary focus was on fusion rates, where staple fixation demonstrated satisfactory results. Most notably, the authors noted higher rates of non-union and complications with staple fixation of Chopart’s joint compared to midfoot/TMT joints.

Take away

Nitinol staples show promising results in compression and stability, particularly when used with supplementary screw fixation. Clinical outcomes seem to vary based on the anatomic location, with DCS performing best at the TMT joints.