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Adjustable Stiffness, External Fixator for the Rat Femur Osteotomy and Segmental Bone Defect Models

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Published on: October 9, 2014

The effect of circular external fixation on limb alignment.

Sanjeev Sabharwal¹, Sameer Badarudeen, Emily McClemens

¹Department of Orthopedics, UMDNJ-New Jersey Medical School, Doctor's Office Center, 90 Bergen St, Suite 7300, Newark, NJ 07103, USA. sabharsa@umdnj.edu

Journal of Pediatric Orthopedics

|March 26, 2008

Summary

Circular external fixators can distort lower limb alignment measurements on standing radiographs. This study found significant discrepancies in mechanical axis deviation and limb length, affecting both operated and contralateral limbs, highlighting potential inaccuracies in assessment.

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Published on: March 24, 2019

Area of Science:

Orthopedic surgery
Radiology
Biomechanical analysis

Background:

Full-length standing radiographs are standard for lower limb alignment assessment.
The impact of circular external fixators on radiographic alignment is not well-documented.

Purpose of the Study:

To evaluate the effect of circular external fixators on lower extremity radiographic alignment and limb length measurements.

Main Methods:

29 patients (31 limbs) with corrected angular deformities underwent standing radiographs before and after fixator removal.
Measurements of frontal plane alignment, limb length, and rotation were analyzed for discrepancies.

Main Results:

Significant differences in mechanical axis deviation (MAD) and limb length were observed in both ipsilateral and contralateral limbs.
Increased MAD and external rotation of the fixated limb correlated with greater measurement discrepancies.
Patient age, sex, BMI, diagnosis, and time between radiographs did not significantly affect discrepancies.

Conclusions:

Standing radiographs with overlying circular external fixators may be unreliable for assessing limb alignment and length.
The fixator can alter the apparent alignment and length of both the operated and the opposite limb.
Clinicians must be aware of these potential imaging pitfalls during lower extremity reconstruction and healing.