In 1981, the concept was delineated of driving staples “in a guided fashion with a rapid and reproducible power source” for fixation in orthopaedic surgery. This transformed an inefficient fixator into an efficient one and secondarily allowed its use in many unique applications for fixation of bone to bone, ligament to bone, and cartilage to bone. From first clinical usage in 1983, it has been used in an estimated 40 000 cases worldwide. Fixation has been for solitary, supplemental, and/or temperary applications in metaphyseal bone for such diverse applications as fusions, osteotomies, fractures, and ligament attachment. The system has been tested and improvements in fixation were demonstrated in laboratory and in vitro studies. The rectangular, rough surfaced, titanium staples were designed for pneumatic insertion to bone and have found use in specific applications as well as a ubiquitous backtable instrument. A learning curve exists for proper usage.
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