5: Computer Assisted External Fixation at Femur Two-Level Posttraumatic Complex Deformity

Fig. 1

(a, b) Pre-operative clinical pictures and (c, d) radiographs of the right femur

3 Preoperative Problem List

(a)

Complex six-component, three-planar two-level deformity of right femur: right MAD = 14 mm lateral; mLPFA = 75 deg.; mLDFA = 85 deg.; mMPTA = 88 deg.; mLDTA = 91 deg.

(b)

Shortening of the right femur = 4 cm.

4 Treatment Strategy

We chose to perform a two-level correction at each apex of deformity. In addition, gradual lengthening will correct the shortening. The deformity correction was performed using the computer-assisted Ortho-SUV frame.

5 Basic Principles

(a)

Use of external fixation provides possibility of simultaneous gradual lengthening and deformity correction.

(b)

Use of computer-assisted Ortho-SUV frame provides precise, one-step gradual deformity correction.

(c)

Two-level deformity is better to correct from two osteotomies made at each center of rotation of angulation (CORA). This may not always be technically possible. If a multilevel deformity is corrected through a resultant CORA, the regenerate will be curved.

(d)

The osteotomies should be made from small incisions not exceeding 1 cm.

(e)

Use of module transformation of the circular external frame is made in response with callosity formation and decreases the bulkiness of the frame.

6 Images During Treatment

See Figs. 2, 3, 4, 5, 6, and 7.

Fig. 2

Clinical pictures and radiographs after surgery: Ortho-SUV frame (two sets of Ortho-SUV frame) is applied and two-level osteotomy of the right femur has been performed

Fig. 3

The Ortho-SUV software window at step 11: planning of deformity correction at the levels of both osteotomies. The bone fragments anatomical axes are drawn. Yellow

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