MedShape, Inc. has announced the launch of the new DynaFrame CF (carbon fiber) Deployment System. The implant, manufactured out of carbon fiber-filled polyetheretherketone (PEEK), is a method for implanting the DynaNail TTC Fusion System. DynaNail is indicated for use in tibiotalocalcaneal (TTC) fusion surgery.
MedShape Launches DynaFrame CF Deployment System

The company wrote in its July 11, 2017 news release, “Clinically introduced in 2012, the DynaNail TTC Fusion System is the first and only internal fusion device to harness the pseudoelastic properties of NiTiNOL to offer the compression performance of an external fixator inside an intramedullary (IM) nail design.”
“Compression has shown to be important in not only keeping the bones in close apposition but also in providing the physiological stresses needed to promote bone healing.”
“DynaNail’s internal NiTiNOL Compressive Element maintains post-operative compression by automatically adapting for up to 6 mm of bone resorption or settling. During surgery, DynaFrame CF is used to insert DynaNail and stretch the NiTiNOL Compressive Element. Once stretched, DynaFrame CF aids in targeting and placing fixation screws across the DynaNail Implant. The Compressive Element is then activated upon removal of DynaFrame CF.”
“The DynaFrame CF Deployment System features a carbon fiber PEEK construction which provides the physician with up to 18X more rigidity than the original PEEK material.”
“Several geometry changes were also implemented including more clearance to the distal end of the DynaFrame and its posterior-anterior Targeting Arm which helps the physician to treat larger patient anatomies. The increased rigidity from the carbon fiber material along with these additional geometry changes eliminates any issues with drill targeting and, therefore, ensures that the physician will be able to perform a fast, simple procedure every time.”
Jeremy Blair, vice president of Research & Development, told OTW, “From a product development standpoint, the game changer was switching from chopped carbon fiber materials to laminate carbon fiber, which is orders of magnitude stiffer than the unfilled PEEK in the original DynaNail Frames. These materials not only have an outsized impact on improving drill targeting reliability, but also increase the amount of intra-operative external compression that the surgeon can apply with the DynaFrame CF.”
“It’s been exciting to see the overwhelmingly positive response surgeons have had to using the new DynaFrame and how it greatly simplifies the procedure. Their first trial has been described as upgrading from a Nissan Leaf to a Tesla Model S. There’s just no going back.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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