One of the stranger side effects of the Roanoke fixation has been the periodic re- discovery" of one of the many multire- discoveryities that dof the rural East.
In most of the series where DCS fixation has been used, either open reduction or biologic fixation has been studied separately [7, 14, 18, 19].
Flexor tendon rupture after volar plate fixation has been reported by some authors [14, 15].
Cementless fixation has been shown to be effective in many settings.
Arthroscopically assisted percutaneous fixation has been performed successfully for such fractures, avoiding extensive surgical dissection.
Anterior transarticular screw (ATAS) fixation has been suggested as a viable alternative to posterior stabilization.
Intramedullary screw fixation has been the most common treatment for fifth metatarsal base fractures.
The durability of fixation has been evaluated up to 20 years with 90% survivorship.
A similar approach of intramedullary fixation has been previously reported for isolated femoral osteotomy in pediatric patients [8].
Open treatment via a direct anterior approach to the AIIS and internal fixation has been described for selected cases [17].
Of these enhancements, screw fixation has been noted as the most important feature of enhanced fixation [4, 9, 12].
