Skomoroshko Petr V, Vilensky Victor A, Hammouda Ahmed I, Fletcher Matt D A, Solomin Leonid N
Vreden Russian Research Institute of Traumatology and Orthopedics, 8 Baykova Street, Saint Petersburg 195427, Russia.
Orthopedic Surgery Department, Al-Azhar University Hospitals, 10B Eltaka Street, El-Mabousin Buildings, 8th Area, Nasr City, Cairo 11371, Egypt.
Adv Orthop. 2014;2014:268567. doi: 10.1155/2014/268567. Epub 2014 Dec 25.
Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for trauma and deformity. One shortcoming of the traditional fixator is its limited ability to correct more than one plane of deformity simultaneously, leading to lengthy frame-time indices. Hexapod circular fixation utilising computer guidance is commonplace for complex multidimensional deformity but difficulties often arise with correction of femoral deformity due to bulkiness of the frame construct, particularly in proximal deformity and in patients of increased size. The Ortho-SUV frame is an innovative hexapod which permits unique customisation to individual patient anatomy to maximise tolerance and optimal range of deformity correction. We hypothesised that the optimal configuration and maximal degree of correction achievable by the Ortho-SUV frame can be biomechanically modelled and applied clinically. A study was constructed using Ortho-SUV and femoral limb models to measure deformity correction via differing frame constructs and determine optimal frame configuration to achieve correction in proximal, middle, and distal third deformities with respect to the soft tissue envelope. The ideal frame configuration is determined for correction of deformity in all locations of the femur with the maximal parameters of correction calculated whilst avoiding and mitigating soft tissue irritation from bulky frame construction.
根据伊里扎洛夫方法进行的环形固定是一种公认的治疗创伤和畸形的方式。传统固定器的一个缺点是其同时矫正多个畸形平面的能力有限，导致固定时间较长。利用计算机引导的六足环形固定对于复杂的多维畸形很常见，但由于框架结构庞大，在矫正股骨畸形时常常出现困难，特别是在近端畸形和体型较大的患者中。Ortho-SUV框架是一种创新的六足框架，允许根据个体患者的解剖结构进行独特定制，以最大限度地提高耐受性和实现最佳的畸形矫正范围。我们假设Ortho-SUV框架可实现的最佳配置和最大矫正程度可以通过生物力学建模并应用于临床。使用Ortho-SUV和股骨肢体模型构建了一项研究，以通过不同的框架结构测量畸形矫正情况，并确定在近端、中部和远端三分之一畸形中相对于软组织包膜实现矫正的最佳框架配置。确定了用于矫正股骨所有部位畸形的理想框架配置，并计算了最大矫正参数，同时避免和减轻庞大框架结构对软组织的刺激。
