Orthoplastic consideration during distal tibia deformity and limb lengthening utilizing truelok hexapod circular external fixator

Background: This case study examines the utilization of Hexapod Truelok circular external fixation as well as the osteotomy site with respect to avoid further damage to the cutaneous perforators on patients that had a poor soft tissue envelope with performing angular lower limb deformity correction within the 55-year-old to 74-year-old age group with underlying comorbidities.

Methods: A prospective study was done on 17 patients with angular tibial/fibular deformities. 9 of them were males and 8 of them were females. Fixation of all cases was performed with utilization of Hexapod Truelok external ring fixation with injection of bone marrow 9X concentrate drawn from the tibia to the osteotomy region during the initial surgical intervention. An additional peripheral blood along with bone marrow concentrate with fluoroscopic percutaneous guided injection was placed into the osteotomy/lengthening site during the post-operative period when the footplate was removed.

Results: Circular Hexapod Truelok external fixation was applied for an average of 17 weeks post-operatively with no non-union, mal-union or infection.

Conclusion: Gradual correction for distal tibial and fibular osteotomy with combined orthoplastic approach allows for improved outcomes to be obtained. Hexapod Truelok application with external ring fixation is a useful alternative with correction of a multiplane deformity simultaneously in an easily applied prescription principle format.