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Pediatric Deformity Correction Using a Multiaxial Correction Fixator

  • Symposium: Advances in Limb Lengthening and Reconstruction
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Circular fixators have been used successfully to correct multiplanar deformities but are often cumbersome and may be difficult to apply. We determined whether a monolateral fixator, which allows for correction of angular deformity and displacement in three planes, can correct lower extremity deformities to within normal radiographic means (anatomic lateral distal femoral angle, anatomic medial proximal tibial angle, and tibial femoral angle). We retrospectively reviewed the clinical records and radiographs of 22 consecutive patients (25 limbs) who underwent deformity correction using a new multiaxial monolateral external fixator. The patients were 4 to 16 years of age. We had a minimum 1.2-year followup (mean, 2.14 years; range, 1.2–3.1 years). Those with primary femoral and tibial deformities had improvements in the mean deviation from normal of the anatomic lateral distal femoral angle, anatomic medial proximal tibial angle and tibial femoral angle. Patients with Blount’s disease had improvements in the mean anatomic medial proximal tibial angle from 59.9º to 87.8º. Five patients had complications (two pin site infections, one premature consolidation, one knee flexion contracture, one recurrence of varus). Six patients developed secondary deformities, all of which were corrected using the primary or secondary hinge. We conclude this fixator can produce satisfactory results with relatively few complications.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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References

  1. Birch JG, Samchukov ML. Use of the Ilizarov method to correct lower limb deformities in children and adolescents. J Am Acad Orthop Surg. 2004;12:144–154.

    PubMed  Google Scholar 

  2. Coogan PG, Fox JA, Fitch RD. Treatment of adolescent Blount disease with circular external fixation device and distraction osteogenesis. J Pediatr Orthop. 1996;16:450–454.

    PubMed  CAS  Google Scholar 

  3. Eidelman M, Bialik V, Katzman A. Correction of deformities in children using the Taylor spatial frame. J Pediatr Orthop B. 2006;15:387–395.

    PubMed  Google Scholar 

  4. Fadel M, Hosny G. The Taylor spatial frame for deformity correction in the lower limbs. Int Orthop. 2005;29:125–129.

    Article  PubMed  Google Scholar 

  5. Feldman DS, Madan SS, Koval KJ, van Bosse HJ, Bazzi J, Lehman WB. Correction of tibia vara with six-axis deformity analysis and Taylor spatial frame. J Pediatr Orthop. 2003;23:387–391.

    Article  PubMed  Google Scholar 

  6. Paley D, ed. Principles of Deformity Correction. Berlin, Germany: Springer-Verlag; 2002:61–89.

    Google Scholar 

  7. Price CT, Scott DS, Greenberg DA. Dynamic axial fixation in the surgical treatment of tibia vara. J Pediatr Orthop. 1995;15:236–243.

    PubMed  CAS  Google Scholar 

  8. Sabharwal S, Badarudeen S, McClemens E, Choung E. The effect of circular fixation on limb alignment. J Pediatr Orthop. 2008;28:314–319.

    PubMed  Google Scholar 

  9. Sluga M, Pfeiffer M, Kotz R, Nehrer S. Lower limb deformities in children: two-stage correction using the Taylor spatial frame. J Pediatr Orthop B. 2003;12:123–128.

    Article  PubMed  Google Scholar 

  10. Stanitski DF, Srivastava P, Stanitski CL. Correction of proximal tibial deformities in adolescents with the T-Garches external fixator. J Pediatr Orthop. 1998;18:512–517.

    Article  PubMed  CAS  Google Scholar 

  11. Tsuchiya H, Uehara K, Abdel-Wanis ME, Sakurakichi K, Kabata T, Tomita K. Deformity correction followed by lengthening with the Ilizarov method. Clin Orthop Relat Res. 2002;402:176–183.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. American Family Children Hospital, Madison, WI, USA

    James J. McCarthy MD

  2. University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI, 53792, USA

    James J. McCarthy MD

  3. Shriners Hospitals for Children, Philadelphia, PA, USA

    Ashish Ranade MD

  4. Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Richard S. Davidson MD

Authors
  1. James J. McCarthy MD
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  2. Ashish Ranade MD
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  3. Richard S. Davidson MD
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Corresponding author

Correspondence to James J. McCarthy MD.

Additional information

One or more of the authors (JJM, RSD) has received funding from EBI/Biomet. The institution of the authors (Shriners Hospitals for Children) has received funding from EBI/Biomet.

Each author certifies that his or her institution has approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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McCarthy, J.J., Ranade, A. & Davidson, R.S. Pediatric Deformity Correction Using a Multiaxial Correction Fixator. Clin Orthop Relat Res 466, 3011–3017 (2008). https://doi.org/10.1007/s11999-008-0491-1

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  • DOI: https://doi.org/10.1007/s11999-008-0491-1

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