The Initial Expirience with Novel Hexapod Circular External Fixator in Fracture Reduction and Limb Reconstruction

Objectives: Temporary frame instability, complexity of strut adjustment, and lack of preoperative
planning are well-known limitations of the existing hexapod-type external fixators. The
purpose of this study was to review the initial experience with a novel hexapod circular fixator in fracture reduction and limb reconstruction.

Material and Methods: Charts and radiographs of 35 patients treated with the TL-Hex circular fixation since December 2012 were retrospectively reviewed. All patients were divided into 2
groups: fracture group (25 patients) and reconstruction group (10 patients). The fracture
group consisted of 19 patients with tibial fractures (including 1 patient with a bilateral
fracture) treated with either a standard TL-Hex frame (16 segments) or with TL-Trauma (TL-Hex rings with rapid adjust struts) assembly (4 segments), 3 patients with femoral fractures
(including 1 patient with bilateral fracture), 1 patient with a combined femoral/tibial fracture, and 2 patients with cable bone transport for segmental tibial bone loss. The second group was composed of 4 patients with tibial varus (including 2 patients with bilateral deformity), 1
patient with bilateral malrotation syndrome, 1 patient with distal femoral valgus, 2 patients with humeral lengthening, 1 patient with neglected clubfoot, 1 patient with ankle arthrodesis for arthritis.

Results: The external fixator required significantly less time for pre-assembly.
All patients in the fracture group achieved desirable reduction and healing while limb
lengthening or/and re-alignment was accomplished in all patients in the limb reconstruction
group. Superior frame stability and reduced rate of superficial pin tract infection was noticed in the majority of patients. No major complications were observed except for one case of nonunion after proximal tibial osteotomy. In this case, the frame was re-applied to the extremity and union was achieved.

Conclusion: The novel hexapod circular external fixator can be successfully applied in the treatment of patients with fractures and limb reconstructions.