Introduction Deformity correction by osteotomy and internal fixation may result in failure to achieve accurate correction. Internal fixation is more convenient for the patient; however, external fixators allow accurate correction of deformities but are uncomfortable. We combine the advantages of the two methods: accuracy of an external fixation together with the patient convenience of internal fixation.
Material and Methods: Table.
Operative technique: A temporary external fixation (Orthofix, AO) is applied and a corrective osteotomy performed. The deformity is acutely corrected and temporary fixed by the external fixator. Either plates or intramedullary nails are used for final fixation. At the end of surgery the external fixator is removed. Results: All deformities accurately corrected except for three patients. Complications: Deep wound infection in a 63 old female Conclusion: An excellent method to correct various deformities, with internal fixation either plates or intramedullary nails.
Table:
Gender |
Males -14 |
Females -9 |
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Age - Years |
6-67 |
Ave: 29 |
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Etiology |
Olier Dis – 1 FHE - 1 |
Fibrous Dysplasia 1 |
# Malunion 5 |
Idiopathic: Valgus 5 MCOA: Varus -2 Idiopathic Varus - 1 |
Renal Rickets - 1 |
Residual C.F - 3 |
C.P = 2 |
MED - 1 |
Segment |
Femurs: 15 |
Tibias: 10 |
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Side |
Rt - 12 |
Lt- 13 |
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FAN |
5 p |
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FAP |
20 p |
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Deformity (segments) |
Valgus 9 |
Varus -12 |
I.R - 3 |
Trans 1 |
A-C- 5 |
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MAD - 14 p |
20 mm - 106 |
-Mean: 49 mm |
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Deformity Angle |
5° - 30° |
Mean:16° |
MAD – Mechanical Axis Deviation, FAN-Fixator Assisted Nailing, FAP – Fixator Assisted Plating, C.F – Clubfoot, C.P – Cerebral Palsy, FHE – Familiar Hereditary Exostosis, A-C– Antecurvatum, Trans – Translation, I.R – Internal Rotation, MCOA – Knee Medial Compartment osteoarthritis, MED – Multiple Epiphyseal Dysplasia