Dr. Ingo Pfeil, Dresden, Germany, began clinical use of the PAUL technique in 2007 to refine the surgical approach and the implant design. Trial and error in the first two years was followed by a more focused development phase and the production of unique ALPS plates.
Controlled clinical release of the PAUL system was initiated in early 2010, expanding to ~30 surgeons worldwide. By early 2012, ~300 cases had been treated. Clinical experience in the United States, Europe and Japan demonstrated reduced complexity and morbidity of the procedure in comparison to other corrective surgical techniques and is meeting the expectations of the early adopters.
Early complication rates were manageable. In most cases, complications were related to technical errors and implant design. Positive reports on the technique and short-term clinical outcomes are encouraging.
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