Addressing non-unions involves stabilizing the affected area through osteosynthesis and improving bone biology using bone grafts. However, there is no consensus on the optimal treatment method. This study aims to compare outcomes of non-union surgery using conventional treatment methods (metal hardware ± graft) versus osteosynthesis with the human allogeneic cortical bone screw (Shark Screw^®) alone or in combination with a metallic plate. Thirty-four patients underwent conventional treatment, while twenty-eight cases received one or more Shark Screws^®. Patient demographics, bone healing, time to bone healing, and complications were assessed. Results revealed a healing rate of 96.4% for the Shark Screw^® group, compared to 82.3% for the conventionally treated group. The Shark Screw^® group exhibited a tendency for faster bone healing (9.4 ± 3.2 vs. 12.9 ± 8.5 weeks, p = 0.05061). Hardware irritations led to six metal removals in the conventional group versus two in the Shark Screw^® group. The Shark Screw^® emerges as a promising option for personalized non-union treatment in the foot, ankle, and select lower leg cases, facilitating effective osteosynthesis and grafting within a single construct and promoting high union rates, low complications, and a rapid healing process.

Magnesium alloys have recently become the focus of research, as these implants exhibit suitable biocompatibility and appropriate mechanical properties (Grün et al., 2018 [1]).

Addressing non-unions involves stabilizing the affected area through osteosynthesis and improving bone biology using bone grafts. However, there is no consensus on the optimal treatment method. This study aims to compare outcomes of non-union revision using conventional treatment methods (metal hardware ± graft) versus osteosynthesis with the human, allogeneic cortical bone screw (Shark Screw®). Thirty-four patients underwent conventional treatment, while 28 cases received Shark Screws®. Patient demographics, bone healing, time to bone healing, and complications were assessed. Results revealed a healing rate of 96.4% for the Shark Screw® group, compared to 82.3% for the conventionally treated group. The Shark Screw® group exhibited a tendency for faster bone healing (9.4±3.2 vs. 12.9±8.5 weeks, p=0.05061). Hardware irritations led to six metal removals in the conventional group versus two in the Shark Screw® group. The Shark Screw® emerges as a promising option for personalized non-union treatment in the foot, ankle, and select lower leg cases, facilitating effective osteosynthesis and grafting within a single construct, promoting high union rates, low complications, and a rapid healing process.

Background: Talar neck fractures are complex injuries that become particularly challenging when accompanied by bone loss or comminution. This case report introduces the use of an allograft bone screw as a novel method for bridging lateral comminution at the talar neck, providing structural support and promoting bone regeneration. Methods: A 20-year-old male sustained a comminuted talar neck fracture with subtalar and tibiotalar dislocation after a bouldering fall. Urgent surgical intervention involved open reduction and internal fixation using a two-incision technique. The medial key fragment was stabilized with two conventional compression screws, revealing a significant lateral bony defect. This was bridged and stabilized with an allogeneic cortical bone screw (Shark Screw^®, Surgebright GmbH, Lichtenberg, Austria), supplemented by bone replacement material. Results: At three months, CT confirmed fracture healing, and weight-bearing was initiated. At six months, the AOFAS score was 85/100 and FAAM 69/84, with no significant pain or swelling. By one year, the patient demonstrated full weight-bearing with occasional pain (AOFAS 88/100, FAAM 79/84). At two years, the patient achieved a pain-free range of motion and full activity participation (AOFAS 100/100, FAAM 83/84). Conclusions: The successful application of this technique illustrates the potential of allograft bone screws for stabilizing and bridging defects in talar neck fractures.