Correction of lower limb deformities with fixator assisted nailing

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Radiology

Background:

• Lower extremity deformities require surgical correction to restore mechanical axis and joint alignment.
• Traditional methods include osteotomy with external or internal fixation.
• External fixator assisted internal fixation with intramedullary (IM) nailing is a gold standard but requires specialized expertise.

Observation:

• A retrospective study analyzed 13 patients undergoing fixator assisted IM nailing for lower limb deformities between 2010-2017.
• Radiological parameters (MAD, aLDFA, mLDFA, MPTA) and functional outcomes were assessed pre- and post-operatively.
• The study included 29 long bone corrections (16 femur, 13 tibia).

Findings:

• Fixator assisted IM nailing significantly improved Mechanical Axis Deviation (MAD) from a mean of 38.87 mm to 17.54 mm.
• Most patients achieved normal range of motion and had no functional limitations post-surgery.
• Complications were minimal, with only two cases of knee stiffness requiring manipulation and one of toe extension weakness that resolved.

Implications:

• Fixator assisted IM nailing offers a superior approach for lower limb deformity correction by combining benefits of external and internal fixation.
• This technique can prevent complications like knee stiffness associated with external fixators.
• It provides a more convenient and effective treatment option for patients with lower limb deformities.