IO Freedom is an intraosseous fixation system for fusion of the foot and ankle. A cannulated lag screw is placed across the joint, then a Freedom X-Post, a metallic bone bridge, is inserted beside the screw head; the screw is tightened against the X-Post to compress the joint. The whole construct sits within the bone.
Features
- Zero-profile construct: lag screw and X-Post placed within the bone.
- Lag screw compresses against the X-Post, a metallic bone bridge.
- Three sizes: 3.5, 4.5 and 6.5 mm, each with short and long thread lag screws.
- X-Post angle adjustable from 55° to 80° to the screw.
- Self-drilling, self-tapping cannulated screws.
- Small instrument footprint, for standard or minimally invasive approaches.
Indications
Reduction and internal fixation of arthrodeses, osteotomies, intra- and extra-articular fractures and non-unions of the small bones and joints of the hand, wrist, foot and ankle, appropriate for the size of the device.
The surgical technique illustrates a Lapidus fusion; the case study describes a talonavicular arthrodesis.
Indications, contraindications, warnings and precautions are listed in the instructions for use (IFU).
How it works
- A guidewire is placed across the prepared joint and the cannulated lag screw is inserted, stopping short with a screw stop washer or key.
- The X-Post drill guide seats in the screw head. The X-Post legs can be angled at 55° to 80° to the screw and are placed on either side of it, roughly parallel to the joint.
- The X-Post is inserted and tamped flush with the bone.
- The lag screw is advanced into the X-Post's recess, which acts as a stop, until compression is felt. The screw is not a locking screw, so it should not be over-tightened.
A lag screw can also be used on its own, with or without a washer.
Implants
- Cannulated lag screws: 3.5, 4.5 and 6.5 mm, each with short and long threads; self-drilling and self-tapping. The short thread is recommended when the screw starts more than 15 mm from the joint line.
- Freedom X-Posts: one size for each screw diameter; legs 15 to 30 mm (3.5 and 4.5 mm) or 20 to 35 mm (6.5 mm).
- Screw washers and screw stop washers for each diameter.
Instruments
- Guidewires (1.4, 1.6 and 2.0 mm) and wire depth gauges.
- Cannulated drills (2.5, 3.0 and 4.5 mm).
- Lag screw and X-Post countersinks for each size.
- X-Post drill guides and drill pins (2.0 and 2.5 mm, 125 and 200 mm).
- X-Post inserter, screw stop keys, T15 and T25 drivers, ratcheting handles.
- Joint preparation rasp and fenestrating drill.
Sizes and ordering
Codes are from the IO Freedom surgical technique (Rev A, 09/2021); 118-45238 and the 6.5 mm 100 to 110 mm long-thread codes are confirmed in the US FDA device database (GUDID). Instrument codes are listed in the surgical technique.
Freedom X-Posts12 items
| Ref. | X-Post size | Leg length |
|---|---|---|
| 147-35815 | 3.5 mm | 15 mm |
| 147-35820 | 3.5 mm | 20 mm |
| 147-35825 | 3.5 mm | 25 mm |
| 147-35830 | 3.5 mm | 30 mm |
| 147-45815 | 4.5 mm | 15 mm |
| 147-45820 | 4.5 mm | 20 mm |
| 147-45825 | 4.5 mm | 25 mm |
| 147-45830 | 4.5 mm | 30 mm |
| 147-65820 | 6.5 mm | 20 mm |
| 147-65825 | 6.5 mm | 25 mm |
| 147-65830 | 6.5 mm | 30 mm |
| 147-65835 | 6.5 mm | 35 mm |
Cannulated lag screws, Ø 3.5 mm21 items
| Ref. | Thread | Length |
|---|---|---|
| 147-35220 | Short | 20 mm |
| 147-35222 | Short | 22 mm |
| 147-35224 | Short | 24 mm |
| 147-35226 | Short | 26 mm |
| 147-35228 | Short | 28 mm |
| 147-35230 | Short | 30 mm |
| 147-35232 | Short | 32 mm |
| 147-35234 | Short | 34 mm |
| 147-35236 | Short | 36 mm |
| 147-35238 | Short | 38 mm |
| 147-35240 | Short | 40 mm |
| 147-35245 | Short | 45 mm |
| 147-35250 | Short | 50 mm |
| 147-35130 | Long | 30 mm |
| 147-35132 | Long | 32 mm |
| 147-35134 | Long | 34 mm |
| 147-35136 | Long | 36 mm |
| 147-35138 | Long | 38 mm |
| 147-35140 | Long | 40 mm |
| 147-35145 | Long | 45 mm |
| 147-35150 | Long | 50 mm |
Cannulated lag screws, Ø 4.5 mm25 items
| Ref. | Thread | Length |
|---|---|---|
| 118-45230 | Short | 30 mm |
| 118-45232 | Short | 32 mm |
| 118-45234 | Short | 34 mm |
| 118-45236 | Short | 36 mm |
| 118-45238 | Short | 38 mm |
| 118-45240 | Short | 40 mm |
| 118-45245 | Short | 45 mm |
| 118-45250 | Short | 50 mm |
| 118-45255 | Short | 55 mm |
| 118-45260 | Short | 60 mm |
| 118-45120 | Long | 20 mm |
| 118-45122 | Long | 22 mm |
| 118-45124 | Long | 24 mm |
| 118-45126 | Long | 26 mm |
| 118-45128 | Long | 28 mm |
| 118-45130 | Long | 30 mm |
| 118-45132 | Long | 32 mm |
| 118-45134 | Long | 34 mm |
| 118-45136 | Long | 36 mm |
| 118-45138 | Long | 38 mm |
| 118-45140 | Long | 40 mm |
| 118-45145 | Long | 45 mm |
| 118-45150 | Long | 50 mm |
| 118-45155 | Long | 55 mm |
| 118-45160 | Long | 60 mm |
Cannulated lag screws, Ø 6.5 mm30 items
| Ref. | Thread | Length |
|---|---|---|
| 136-65140 | Short | 40 mm |
| 136-65145 | Short | 45 mm |
| 136-65150 | Short | 50 mm |
| 136-65155 | Short | 55 mm |
| 136-65160 | Short | 60 mm |
| 136-65165 | Short | 65 mm |
| 136-65170 | Short | 70 mm |
| 136-65175 | Short | 75 mm |
| 136-65180 | Short | 80 mm |
| 136-65185 | Short | 85 mm |
| 136-65190 | Short | 90 mm |
| 136-65195 | Short | 95 mm |
| 136-65100 | Short | 100 mm |
| 136-65105 | Short | 105 mm |
| 136-65110 | Short | 110 mm |
| 136-65240 | Long | 40 mm |
| 136-65245 | Long | 45 mm |
| 136-65250 | Long | 50 mm |
| 136-65255 | Long | 55 mm |
| 136-65260 | Long | 60 mm |
| 136-65265 | Long | 65 mm |
| 136-65270 | Long | 70 mm |
| 136-65275 | Long | 75 mm |
| 136-65280 | Long | 80 mm |
| 136-65285 | Long | 85 mm |
| 136-65290 | Long | 90 mm |
| 136-65295 | Long | 95 mm |
| 136-65200 | Long | 100 mm |
| 136-65205 | Long | 105 mm |
| 136-65210 | Long | 110 mm |
Screw washers3 items
| Ref. | Description |
|---|---|
| 147-35600 | 3.5 mm screw washer |
| 148-35451 | 4.5 mm screw washer |
| 147-65600 | 6.5 mm screw washer |
Codes and sizes are taken from the manufacturer's marketing literature and may change. For current information, check the Extremity Medical website or the instructions for use before ordering.
Surgical Technique, Brochure & Case Study
IO Freedom animation
Product information
Can the lag screw be used without the X-Post?
Yes. The lag screw can be placed on its own, with a standard screw washer if required; use the screw countersink rather than the X-Post countersink.
Which thread length should I use?
Each diameter comes in short and long threads. The surgical technique recommends a short thread when the screw starts more than 15 mm from the joint line.
How are the implants removed?
Remove the lag screw first, then lift and tamp out the X-Post with the inserter or forceps.
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