The Medial Column Screw (MCS) in Calcaneal/Midfoot Trauma
When a calcaneal fracture is part of a “complex foot” injury (like a high-velocity crush or a fall), the surgeon isn’t just worried about the heel; they are worried about the arch (the medial column) collapsing.
Why 7mm and 5mm?
These numbers refer to the diameter of the cannulated screws used for fixation. In the operating theatre, these are heavy-duty screws designed to “bridge” joints or compress large bone fragments.
- BLUE 7.0mm MCS – 2.2mm Kwire – T25 – 4.8mm Drill – P>A : This is a large-diameter screw, often used for primary stabilization of the medial column. It typically runs from the head of the first metatarsal, through the cuneiform, and into the talus or calcaneus. Because it is 7mm, it provides massive “lag” force to hold the arch together.
- PINK 5.0mm MCS – 1.6mm Kwire – T15 – 3.8mm Drill – L>M : These are used when the bone anatomy is smaller (perhaps in the midfoot or in a smaller patient) or as a secondary “position screw” to prevent the foot from rotating around the larger 7mm screw.
