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Simultaneous multisegmental and multifocal corrections of complex lower limb deformities with a hexapod external
Victor Ray1, Dmitry Popkov2, Pierre Lascombes3
1Service de chirurgie orthopédique et traumatologique pédiatrique, Hôpital d'enfant, CHU Nancy, Rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|August 14, 2021
Summary
Simultaneous multilevel correction of pediatric lower limb deformities using external fixators is feasible. This approach reduces treatment time without increasing complications or compromising results.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Limb deformity correction
Background:
- External fixators are crucial for complex pediatric lower limb deformity correction.
- Current treatments are lengthy and significantly impact patients and families.
- Simultaneous multisegmental and/or multifocal correction is explored to reduce treatment duration.
Purpose of the Study:
- To evaluate the efficacy and safety of simultaneous multilevel correction for pediatric lower limb deformities.
- To compare complication rates and outcomes with sequential correction methods.
Main Methods:
- A retrospective study of 16 pediatric patients treated with hexapod external fixators.
- Corrections involved 23 limbs (12 femurs, 20 tibias) with 53 osteotomies.
- Outcomes assessed using mechanical axis deviation (MAD), limb length discrepancy (RLLD), and angular healing index (AHI).
Main Results:
- Significant improvements in MAD (30 to 13.5 mm) and RLLD (33.2 to 6.9 mm) were observed.
- The mean AHI was 74.1 days/cm.
- The overall complication rate was 56.5%, with most being low-grade.
Conclusions:
- One-stage multilevel corrections are technically challenging but feasible.
- This method reduces total treatment duration without compromising results or increasing complication rates.
- Simultaneous correction offers a viable alternative to successive procedures for complex pediatric limb deformities.
