Correction of all deformities in a single planned session with the application of a spider frame fixator

Abstract

Objectives. This study aimed to demonstrate the simultaneous correction of all deformities with the Spider Frame computer-assisted external fixation system, to determine the characteristics of the application technique, and to evaluate its effectiveness, complications and results. Materials and Methods. The evaluation was performed on 22 patients treated with a spider frame between 2012 and 2014. The lengthening amount, union status and bone angles were evaluated radiologically on the pre and postoperative orthoroentgenograms. In the preoperative evaluation, the Paley difficulty scale was used; the postoperative bone and functional results were evaluated according to the Paley criteria. The external fixator index and distraction index were evaluated. Results. The mean score of the Paley difficulty scale applied preoperatively, was 4.5 (range, 1-10). The mean duration of the fixator was 199 days (range, 104-300 days). The mean external fixator index was 105.3 day/cm (range, 38-300 day/cm). The mean distraction index was 11.4 day/cm (range, 7-22 day/cm). According to the Paley criteria, excellent and good results were obtained in 75% and moderate results in 25% of cases involving the femur. In the tibia cases, excellent and good functional results were obtained in 83.3% and excellent and good bone results in 91.6% patients. Conclusion. In cases of deformity, acute fracture and nonunion, the computer-assisted external fixator system (spider frame® ) without any modification provides single-stage correction by allowing postoperative intervention to the deformity. It is a new generation external fixator system which has shown successful functional results, and can therefore be considered for use.