Skip to main content
Top
Published in: International Orthopaedics 11/2013

01-11-2013 | Original Paper

Comparative clinical study on deformity correction accuracy of different external fixators

Authors: Ilker Eren, Levent Eralp, Mehmet Kocaoglu

Published in: International Orthopaedics | Issue 11/2013

Login to get access

Abstract

Purpose

In this study, the correction accuracy of Smart Correction spatial fixators and of Ilizarov-type external fixators are compared in terms of deformity complexity.

Methods

Seventy-seven (40 male, 37 female) bone segments of 57 patients treated with a Smart Correction device were compared with 94 (51 male, 43 female) segments of 68 patients treated with an Ilizarov fixator. Mean age of the Smart Correction group was 20.69 ± 12.94 years, and or the Ilizarov group 22.45 ± 12.18 years. Patients were categorised according to limb lengthening and the number of deformity planes.

Results

A longer correction period was found with Ilizarov (66.53 ± 47.7 days) compared with Smart Correction (49.05 ± 35.6 days) devices. The bone healing index of the Ilizarov group was significantly better compared with the spatial group. Residual deformity after treatment was significantly lower with the Smart Correction device; however, this relationship could not be shown between subgroups. Although there was no significant difference between subgroups, mean residual deformity was higher with the increasing number of planes of the deformity.

Conclusions

The Smart Correction fixator is an accurate device that allows ease of application and planning. It demonstrates higher accuracy for correcting deformities compared with an Ilizarov external fixator. With an increasing number of planes, the difference between the two devices becomes even more pronounced. The relationship between the complexity of the deformity and residual deformity may possibly be significantly greater in favour of the Smart Correction fixator in a study with a larger sample size.
Literature
1.
go back to reference Adams F (1939) Hippocrates, the works of Hippocrates. Williams & Wilkins, Baltimore Adams F (1939) Hippocrates, the works of Hippocrates. Williams & Wilkins, Baltimore
3.
go back to reference Sisk TD (1983) External fixation. Historic review, advantages, disadvantages, complications, and indications. Clin Orthop Relat Res 180:15–22PubMed Sisk TD (1983) External fixation. Historic review, advantages, disadvantages, complications, and indications. Clin Orthop Relat Res 180:15–22PubMed
4.
go back to reference Codivilla A (1905) On the means of lengthening in the lower limbs, the muscles and tissues which are shortened through deformity. Am J Orthop Surg 2:353–369 Codivilla A (1905) On the means of lengthening in the lower limbs, the muscles and tissues which are shortened through deformity. Am J Orthop Surg 2:353–369
5.
go back to reference Manner HM, Huebl M, Radler C, Ganger R, Petje G, Grill F (2007) Accuracy of complex lower-limb deformity correction with external fixation: a comparison of the Taylor Spatial Frame with the Ilizarov ring fixator. J Child Orthop 1(1):55–61. doi:10.1007/s11832-006-0005-1 PubMedCrossRef Manner HM, Huebl M, Radler C, Ganger R, Petje G, Grill F (2007) Accuracy of complex lower-limb deformity correction with external fixation: a comparison of the Taylor Spatial Frame with the Ilizarov ring fixator. J Child Orthop 1(1):55–61. doi:10.​1007/​s11832-006-0005-1 PubMedCrossRef
6.
go back to reference Paley D, Herzenberg JE (2003) Principles of Deformity Correction. Springer, Berlin Paley D, Herzenberg JE (2003) Principles of Deformity Correction. Springer, Berlin
7.
go back to reference Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of multiapical frontal plane angular and bowing deformities of the femur and tibia. Clin Orthop Relat Res 280:65–71PubMed Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of multiapical frontal plane angular and bowing deformities of the femur and tibia. Clin Orthop Relat Res 280:65–71PubMed
8.
go back to reference Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res 280:48–64PubMed Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res 280:48–64PubMed
9.
go back to reference Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A (1994) Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin N Am 25(3):425–465 Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A (1994) Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin N Am 25(3):425–465
10.
go back to reference Fischgrund J, Paley D, Suter C (1994) Variables affecting time to bone healing during limb lengthening. Clin Orthop Relat Res 301:31–37PubMed Fischgrund J, Paley D, Suter C (1994) Variables affecting time to bone healing during limb lengthening. Clin Orthop Relat Res 301:31–37PubMed
11.
go back to reference Paley D, Chaudray M, Pirone AM, Lentz P, Kautz D (1990) Treatment of malunions and mal-nonunions of the femur and tibia by detailed preoperative planning and the Ilizarov techniques. Orthop Clin N Am 21(4):667–691 Paley D, Chaudray M, Pirone AM, Lentz P, Kautz D (1990) Treatment of malunions and mal-nonunions of the femur and tibia by detailed preoperative planning and the Ilizarov techniques. Orthop Clin N Am 21(4):667–691
12.
go back to reference Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81–104PubMed Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81–104PubMed
13.
go back to reference Watanabe K, Tsuchiya H, Sakurakichi K, Matsubara H, Tomita K (2007) Double-level correction with the Taylor Spatial Frame for shepherd’s crook deformity in fibrous dysplasia. J Orthop Sci 12(4):390–394PubMedCrossRef Watanabe K, Tsuchiya H, Sakurakichi K, Matsubara H, Tomita K (2007) Double-level correction with the Taylor Spatial Frame for shepherd’s crook deformity in fibrous dysplasia. J Orthop Sci 12(4):390–394PubMedCrossRef
14.
go back to reference Seide K, Wolter D, Kortmann HR (1999) Fracture reduction and deformity correction with the hexapod Ilizarov fixator. Clin Orthop Relat Res 363:186–195PubMedCrossRef Seide K, Wolter D, Kortmann HR (1999) Fracture reduction and deformity correction with the hexapod Ilizarov fixator. Clin Orthop Relat Res 363:186–195PubMedCrossRef
15.
go back to reference Sluga M, Pfeiffer M, Kotz R, Nehrer S (2003) Lower limb deformities in children: two-stage correction using the Taylor spatial frame. J Pediatr Orthop B 12(2):123PubMed Sluga M, Pfeiffer M, Kotz R, Nehrer S (2003) Lower limb deformities in children: two-stage correction using the Taylor spatial frame. J Pediatr Orthop B 12(2):123PubMed
16.
go back to reference Sala F, Albisetti W, Capitani D (2010) Versatility of Taylor Spatial Frame in Gustilo-Anderson III C femoral fractures: report of three cases. Musculoskelet Surg 94(2):103–108PubMedCrossRef Sala F, Albisetti W, Capitani D (2010) Versatility of Taylor Spatial Frame in Gustilo-Anderson III C femoral fractures: report of three cases. Musculoskelet Surg 94(2):103–108PubMedCrossRef
17.
go back to reference Waizy H, Windhagen H, Stukenborg-Colsman C, Floerkemeier T (2011) Taylor spatial frame in severe foot deformities using double osteotomy: technical approach and primary results. Int Orthop 35(10):1489–1495PubMedCrossRef Waizy H, Windhagen H, Stukenborg-Colsman C, Floerkemeier T (2011) Taylor spatial frame in severe foot deformities using double osteotomy: technical approach and primary results. Int Orthop 35(10):1489–1495PubMedCrossRef
21.
go back to reference Feldman DS, Madan SS, Koval KJ, van Bosse HJ, Bazzi J, Lehman WB (2003) Correction of tibia vara with six-axis deformity analysis and the Taylor Spatial Frame. J Pediatr Orthop 23(3):387–391PubMed Feldman DS, Madan SS, Koval KJ, van Bosse HJ, Bazzi J, Lehman WB (2003) Correction of tibia vara with six-axis deformity analysis and the Taylor Spatial Frame. J Pediatr Orthop 23(3):387–391PubMed
Metadata
Title
Comparative clinical study on deformity correction accuracy of different external fixators
Authors
Ilker Eren
Levent Eralp
Mehmet Kocaoglu
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 11/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2116-x

Other articles of this Issue 11/2013

International Orthopaedics 11/2013 Go to the issue