Analysis of strut-to-bone lengthening ratio for hexapod frames using mathematical modeling

Abstract

Background: Hexapod external fixators often incorporate bone lengthening as part of a multi-planar deformity correction plan. The hexapod struts, however, do not distract in the direction of bone lengthening. Their oblique orientation to the ring creates a vector that is the summation of multiple individual strut adjustments. We demonstrate that a 1 mm lengthening of each of all six struts always created more than 1 mm of lengthening at the bone. Methods: The amount of lengthening was analyzed with the Taylor Spatial Frame™ (Smith and Nephew, Memphis, TN, USA) software using two different methods. Results: As the strut lengths got longer the ratio got closer to one but it never reached 1.0. Conclusions: This information is critical when using very short struts or very large rings. In these two scenarios, the Δ frame height relative to the Δ strut length becomes much greater than one. Clinical Relevance: A strut length much greater than one will cause the bone to lengthen much faster than the surgeon desires. It may also lead to unhealthy regenerate bone formation and could create delays in bone healing.

Keywords

• External fixation
• multiplanar deformity
• strut adjustment