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Circular hexapod external fixation for periprosthetic tibial fracture
Michael J Assayag1, Noam Bor2,3, Guy Rubin2
1Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY, USA.
Arthroplasty Today
|June 14, 2018
Summary
This study shows circular hexapod external fixation is effective for treating periprosthetic tibia fractures around knee replacements. This technique provides stable fixation and promotes quick healing with minimal complications.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Periprosthetic tibia fractures near total knee arthroplasty (TKA) present challenges due to poor soft tissue and limited screw fixation options.
- The tibial stem in well-fixed TKAs compromises space for traditional fixation methods.
Purpose of the Study:
- To evaluate the practicability and effectiveness of a novel surgical technique for periprosthetic tibia fracture fixation.
- To assess the use of circular hexapod external fixation in patients with compromised bone stock and soft tissues around a TKA.
Main Methods:
- A novel surgical technique utilizing circular hexapod external fixation was applied to 2 patients with periprosthetic tibia fractures.
- Careful pin placement avoided contact with the prosthesis.
- Web-based software facilitated gradual, multi-planar reduction.
Main Results:
- The technique achieved adequate fixation, stability, and reduction in both cases.
- Patients experienced quick healing with minimal complications.
- Both patients returned to their pre-fracture activity levels within months of device removal.
Conclusions:
- Circular hexapod external fixation is a viable and effective solution for periprosthetic tibia fractures in challenging clinical scenarios.
- This method offers a minimally invasive approach with good functional outcomes.
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