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Center for Limb Lengthening & Reconstruction, Mumbai
Hexapod Assisted Correction
Dr Mangal Parihar
1
Center for Limb Lengthening & Reconstruction, Mumbai
Hexapod Assisted Fracture
Reduction
• 48 Year Male
• Vehicular Accident
• 2 weeks Post Injury
• Comminuted Compound
 TypeVI Schatzker Fracture
2
Center for Limb Lengthening & Reconstruction, Mumbai
Preop Xrays
3
Center for Limb Lengthening & Reconstruction, Mumbai
3D CT Pictures
4
Center for Limb Lengthening & Reconstruction, Mumbai 5
Center for Limb Lengthening & Reconstruction, Mumbai
Problem List
• Wound
• Intra-articular Comminution
• Maintain vascularity of bone fragments
• Stable fixation
6
Center for Limb Lengthening & Reconstruction, Mumbai
Steps
• Indirect Intra-articular Reduction
• Raft Screw
• Ilizarov Fixator Application
• Hexapod Assisted Correction
• Mobilization
• Wound Management
7
Center for Limb Lengthening & Reconstruction, Mumbai
Carm Pictures of Intra-
articular reduction
8
Center for Limb Lengthening & Reconstruction, Mumbai
Elevation of Depressed Lateral
Condyle
9
Center for Limb Lengthening & Reconstruction, Mumbai 10
Center for Limb Lengthening & Reconstruction, Mumbai 11
Center for Limb Lengthening & Reconstruction, Mumbai
Reduction Achieved
12
Center for Limb Lengthening & Reconstruction, Mumbai
Raft Screw
13
Center for Limb Lengthening & Reconstruction, Mumbai
Genex Instillation
14
Center for Limb Lengthening & Reconstruction, Mumbai
Ilizarov Fixator
15
Center for Limb Lengthening & Reconstruction, Mumbai
Hexapod Calculations
• Distraction
• Angulation
• Anterior
Translation
16
Center for Limb Lengthening & Reconstruction, Mumbai
Distraction
Lateral & Anterior Translation
17
Center for Limb Lengthening & Reconstruction, Mumbai
10 Days
18
Lateral & Anterior Translation
Compression
Center for Limb Lengthening & Reconstruction, Mumbai
12 Days
19
Center for Limb Lengthening & Reconstruction, Mumbai 20
Center for Limb Lengthening & Reconstruction, Mumbai
Conversion To Straight Rods
21
Center for Limb Lengthening & Reconstruction, Mumbai
2.5 Weeks Post Surgery
22
Center for Limb Lengthening & Reconstruction, Mumbai
2.5 Weeks Post Surgery
• 3 wires in prox
fragment
• 1 wire and 1 schanz
screw in the middle
& distal ring
23
Center for Limb Lengthening & Reconstruction, Mumbai
Center for Limb Lengthening & Reconstruction, Mumbai
Incisions
25
Center for Limb Lengthening & Reconstruction, Mumbai
Evolution Of Wound Over 3
weeks
26
Center for Limb Lengthening & Reconstruction, Mumbai
5 Months - AP
27
Center for Limb Lengthening & Reconstruction, Mumbai
5 Months - Lat
28
Center for Limb Lengthening & Reconstruction, Mumbai
Post Fixator Removal
29
Center for Limb Lengthening & Reconstruction, Mumbai 30
Center for Limb Lengthening & Reconstruction, Mumbai
Scars
31
Center for Limb Lengthening & Reconstruction, Mumbai
Function
32
Center for Limb Lengthening & Reconstruction, Mumbai
Function at 1 Year
33
Center for Limb Lengthening & Reconstruction, Mumbai
Xrays At 1 Year
34
Center for Limb Lengthening & Reconstruction, Mumbai
www.ilizarov.in
35

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Use of Ilizarov fixator Hexapod apparatus for fracture prox tibia

  • 1. Center for Limb Lengthening & Reconstruction, Mumbai Hexapod Assisted Correction Dr Mangal Parihar 1
  • 2. Center for Limb Lengthening & Reconstruction, Mumbai Hexapod Assisted Fracture Reduction • 48 Year Male • Vehicular Accident • 2 weeks Post Injury • Comminuted Compound  TypeVI Schatzker Fracture 2
  • 3. Center for Limb Lengthening & Reconstruction, Mumbai Preop Xrays 3
  • 4. Center for Limb Lengthening & Reconstruction, Mumbai 3D CT Pictures 4
  • 5. Center for Limb Lengthening & Reconstruction, Mumbai 5
  • 6. Center for Limb Lengthening & Reconstruction, Mumbai Problem List • Wound • Intra-articular Comminution • Maintain vascularity of bone fragments • Stable fixation 6
  • 7. Center for Limb Lengthening & Reconstruction, Mumbai Steps • Indirect Intra-articular Reduction • Raft Screw • Ilizarov Fixator Application • Hexapod Assisted Correction • Mobilization • Wound Management 7
  • 8. Center for Limb Lengthening & Reconstruction, Mumbai Carm Pictures of Intra- articular reduction 8
  • 9. Center for Limb Lengthening & Reconstruction, Mumbai Elevation of Depressed Lateral Condyle 9
  • 10. Center for Limb Lengthening & Reconstruction, Mumbai 10
  • 11. Center for Limb Lengthening & Reconstruction, Mumbai 11
  • 12. Center for Limb Lengthening & Reconstruction, Mumbai Reduction Achieved 12
  • 13. Center for Limb Lengthening & Reconstruction, Mumbai Raft Screw 13
  • 14. Center for Limb Lengthening & Reconstruction, Mumbai Genex Instillation 14
  • 15. Center for Limb Lengthening & Reconstruction, Mumbai Ilizarov Fixator 15
  • 16. Center for Limb Lengthening & Reconstruction, Mumbai Hexapod Calculations • Distraction • Angulation • Anterior Translation 16
  • 17. Center for Limb Lengthening & Reconstruction, Mumbai Distraction Lateral & Anterior Translation 17
  • 18. Center for Limb Lengthening & Reconstruction, Mumbai 10 Days 18 Lateral & Anterior Translation Compression
  • 19. Center for Limb Lengthening & Reconstruction, Mumbai 12 Days 19
  • 20. Center for Limb Lengthening & Reconstruction, Mumbai 20
  • 21. Center for Limb Lengthening & Reconstruction, Mumbai Conversion To Straight Rods 21
  • 22. Center for Limb Lengthening & Reconstruction, Mumbai 2.5 Weeks Post Surgery 22
  • 23. Center for Limb Lengthening & Reconstruction, Mumbai 2.5 Weeks Post Surgery • 3 wires in prox fragment • 1 wire and 1 schanz screw in the middle & distal ring 23
  • 24. Center for Limb Lengthening & Reconstruction, Mumbai
  • 25. Center for Limb Lengthening & Reconstruction, Mumbai Incisions 25
  • 26. Center for Limb Lengthening & Reconstruction, Mumbai Evolution Of Wound Over 3 weeks 26
  • 27. Center for Limb Lengthening & Reconstruction, Mumbai 5 Months - AP 27
  • 28. Center for Limb Lengthening & Reconstruction, Mumbai 5 Months - Lat 28
  • 29. Center for Limb Lengthening & Reconstruction, Mumbai Post Fixator Removal 29
  • 30. Center for Limb Lengthening & Reconstruction, Mumbai 30
  • 31. Center for Limb Lengthening & Reconstruction, Mumbai Scars 31
  • 32. Center for Limb Lengthening & Reconstruction, Mumbai Function 32
  • 33. Center for Limb Lengthening & Reconstruction, Mumbai Function at 1 Year 33
  • 34. Center for Limb Lengthening & Reconstruction, Mumbai Xrays At 1 Year 34
  • 35. Center for Limb Lengthening & Reconstruction, Mumbai www.ilizarov.in 35