Intraoperative Assistance of External Fixation in Correction of Lower Limbs Skeletal Deformities

נועם בור Eytan Dujovny Guy Rubin Nimrod Rozen
Orthopedic, Emek Medical Center, Afula

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

Age - Years

6-67

Ave: 29

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

Side

Rt - 12

Lt- 13

FAN

5 p

FAP

20 p

Deformity (segments)

Valgus 9

Varus -12

I.R - 3

Trans 1

A-C- 5

MAD - 14 p

20 mm - 106

-Mean: 49 mm

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

נועם בור
MD נועם בור
Emek hospital








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