The Gorilla® Lapidus Arthrodesis System development began around the concept of neutralization plating. A plate designed for the medial wall provides added stiffness since the plate is positioned on its side. Traditionally, medial wall plates add a complicating factor in that the distal screws apply adductory force on the 1st metatarsal as they are tightened to the plate. To combat this, Paragon 28® designed the plates to match the corrected metatarsal position as well as curvature, thus following the principles of a “bent plate technique” to limit the adductory force applied to the metatarsal. In addition, a medial wall plate is better positioned to prevent plantar gapping while avoiding the insertion of the tibialis anterior plantarly. The anatomic plate construct is designed to help reduce soft tissue irritation in an area where ample soft tissue coverage can be a concern with a poorly designed plate construct.
These features were incorporated into all 18 Lapidus Arthrodesis plating options: standard, graft-spanning and medial wall step-off.
A Precision® Guide Lapidus screw guide is provided in the system to allow for placement of a lag screw across the Lapidus Arthrodesis while missing all other screws in the construct.
Paragon 28®’s Design Rationale
Paragon 28® captured the essence of surgeon concerns with the Lapidus procedure by addressing them with several patented features: a medially positioned plate, a ramped plate proximally to avoid tendon irritation, anatomic curvature of the plate to provide a bent plate advantage, a plantar locking arm to better resist the tension side of the joint, and a Precision® Guide Lapidus for crossing screw insertion to avoid collision with the locking plate screws.