Abstract:Purposes This study compared the six-axis external fixator Ortho-SUV Frame (OSF) and the Ilizarov apparatus (IA) in femoral deformity correction. Our specific questions were: (1) which of the fixators (OSF or IA) provides shorter period of femoral deformity correction, and (2) which of the fixators (OSF or IA) provides better accuracy of correction. Methods We retrospectively analysed 123 cases of femoral deformities (127 femora): 45 (47) treated with OSF (20 male and 27 female) and 78 (80) with IA (53 male an… Show more
“…введение Цель коррекции деформации длинных кос-тей может считаться достигнутой, если восста-новлены принятые за норму значения рефе-рентных линий и углов (РЛу) [1,2]. Коррекция сложных (многокомпонентных многоплоскост-ных) деформаций по Илизарову достаточно эффективна, но при этом необходимо пошаго-во выполнять частичный перемонтаж аппара-та для замены унифицированных репозицион-ных узлов.…”
For the treatment of patients with multilevel deformities when there are contraindications for an acute single step correction the external fixation should be applied including orthopedic hexapods. At the same time a separate orthopedic hexapod is used for each level of deformity. This leads to a significant bulkiness of the overall frame assembly. Calculation of deformity correction in the presence of an intermediate fragment (fragments) and practical implementation of correction represent by no means a simple task.Purpose of the study – to perform a clinical approbation of “spring” technique for multilevel correction of long bones deformities and to evaluate the results.Materials and methods. The authors developed an original technique for correcting multilevel deformities using a single orthopedic hexapod. During the procedure the hexapod struts are fixed only to the proximal and distal rings, and the intermediate ring (rings) is fixed to the adjacent supports using the springs – a so-called “spring” technique. The new method has been successfully tested in the treatment of 7 patients with 2 and 3-level deformities of long bones.Results. The reported correction accuracy was 97.6%. The fixation period averaged 47 weeks (from 37 to 54 weeks). In 2 cases the authors observed soft tissues inflammation around of transosseous elements eradicated by the administration of antibiotics. In one patient with post-traumatic deformity a premature consolidation was observed at one of the levels which required re-osteotomy with further correction using two hexapods.Conclusion. Preliminary results demonstrated that the use of simultaneous correction of deformities at several levels applying one orthopedic hexapod Ortho-SUV and springs simplifies correction calculations, provides optimal timing for deformity correction while maintaining the minimal frame dimensions.
“…введение Цель коррекции деформации длинных кос-тей может считаться достигнутой, если восста-новлены принятые за норму значения рефе-рентных линий и углов (РЛу) [1,2]. Коррекция сложных (многокомпонентных многоплоскост-ных) деформаций по Илизарову достаточно эффективна, но при этом необходимо пошаго-во выполнять частичный перемонтаж аппара-та для замены унифицированных репозицион-ных узлов.…”
For the treatment of patients with multilevel deformities when there are contraindications for an acute single step correction the external fixation should be applied including orthopedic hexapods. At the same time a separate orthopedic hexapod is used for each level of deformity. This leads to a significant bulkiness of the overall frame assembly. Calculation of deformity correction in the presence of an intermediate fragment (fragments) and practical implementation of correction represent by no means a simple task.Purpose of the study – to perform a clinical approbation of “spring” technique for multilevel correction of long bones deformities and to evaluate the results.Materials and methods. The authors developed an original technique for correcting multilevel deformities using a single orthopedic hexapod. During the procedure the hexapod struts are fixed only to the proximal and distal rings, and the intermediate ring (rings) is fixed to the adjacent supports using the springs – a so-called “spring” technique. The new method has been successfully tested in the treatment of 7 patients with 2 and 3-level deformities of long bones.Results. The reported correction accuracy was 97.6%. The fixation period averaged 47 weeks (from 37 to 54 weeks). In 2 cases the authors observed soft tissues inflammation around of transosseous elements eradicated by the administration of antibiotics. In one patient with post-traumatic deformity a premature consolidation was observed at one of the levels which required re-osteotomy with further correction using two hexapods.Conclusion. Preliminary results demonstrated that the use of simultaneous correction of deformities at several levels applying one orthopedic hexapod Ortho-SUV and springs simplifies correction calculations, provides optimal timing for deformity correction while maintaining the minimal frame dimensions.
“…Многочисленные исследования свидетельствуют о том, что все ука-занные аппараты повышают точность коррекции деформаций и уменьшают время пребывания в аппа рате [1,3,4,14,16,21]. …”
Section: современные гексаподыunclassified
“…При работе над этим разделом использованы дан ные мировой литературы [7-10, 14, 21] и соб-ственные исследования [1,4,16,20].…”
“…Они нашли свое применение при коррекции сложных деформаций среднего и заднего отделов стопы, кон-трактурах, вывихах и подвывихах крупных суста-вов, а также при лечении переломов [1,5,[7][8][9]19]. Данные устройства значительно увеличили эффек-тивность лечения пациентов за счет высокой точ-ности направленного перемещения костных фраг-ментов и уменьшения времени, необходимого для коррекции деформации [3,11,16]. Однако ни один из существующих гексаподов не лишен недостатков, что открывает перспективы дальнейшего совершен-ствования этой группы устройств.…”
Статья посвящена чрескостным аппаратам, работающим на основе пассивной компьютерной навигации, так называемым гексаподам. Их основное преимущество связано с возможностью выполнять математически точную коррекцию положения костных фрагментов в трех плоскостях и шести степенях свободы на основе расчетов, выполненных специальной прилагаемой к аппарату компьютерной программой. В настоящее время данные устройства получили наибольшее распространение при коррекции деформаций длинных трубчатых костей, однако сфера их эффективного применения этим не ограничивается. В статье описаны история появления данных устройств, их развитие, проведен сравнительный анализ основных гексаподов: TSF (Taylor Spatial Frame), IHA (Ilizarov Hexapod Apparatus), Орто-СУВ.Ключевые слова: чрескостный остеосинтез, гексаподы, компьютерная навигация, коррекция деформаций.
“…Несмотря на широкую распростра-ненность данного устройства в клиническом ис-пользовании, на сегодняшний момент в литерату-ре существуют лишь единичные публикации об его применении . Так, доказана его эффективность при коррекции деформаций бедренной кости у взрослых [12,19] . Не существует публикаций, позволяющих оценить эффективность данного устройства при коррекции деформаций длинных трубчатых костей у детей .…”
Aim. To retrospectively assess treatment outcomes of long bone deformities of the lower extremities accompanied by shortening in pediatric patients using a software-assisted Ortho-SUV Frame.Materials and methods. The accuracy of deformity correction (AC), period of deformity correction (PDC), external fixation index (EFI), and number of complications in 213 patients were retrospectively analyzed.Results. According to different parameters, AC of femur deformity correction (group 1) varied from 90% to 96%. The average length increase was 47 ± 12 mm. The average distraction duration was 38 ± 14 days. The average PDC was 8 ± 6 days for simple deformities (SDs), 14 ± 7 days for moderate deformities (MDs), and 23 ± 12 days for complex deformities (CDs). EFI was 26 ± 8 days/cm for SDs, 31 ± 6 days/cm for MDs, and 35 ± 12 days/cm for CDs. According to different parameters, AC of the lower leg deformity correction (group 2) varied from 89% to 95%. The average length increase was 52 ± 20 mm. The average distraction duration was 45 ± 18 days. PDC was 11 ± 5 days for SDs, 16 ± 9 days for MDs, and 27 ± 16 days for CDs. EFI was 32 ± 14 days/cm for SDs, 42 ± 12 days/cm for MDs, and 49 ± 8 days/cm for CDs. There were 48 (50.5%) complications in group I with the majority (71%) classified as Caton grade I and 29% as grade II. There were 62 (45%) complications in group 2, where 50% were Caton grade I and 50% were Caton grade II. There were no serious complications (Caton grade III) in either group that influenced the final functional results.Conclusion: Use of a software-assisted Ortho-SUV Frame increased the efficiency of treatment of pediatric patients with long bone deformities because of the great accuracy of deformity correction.
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