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General Orthopaedics

THE RESULTS OF TWO-RING HEXAPODS IN THE LOWER LIMB AT KING'S COLLEGE HOSPITAL

The British Limb Reconstruction Society (BLRS) Annual Meeting 2024, Glasgow, Scotland, 14–15 March 2024.



Abstract

Introduction

Classical fixation using a circular frame involves two rings per segment and in many units this remains the norm whether using ilizarov or hexapod type frames. We present the results of two ring circular frame at King's College Hospital.

Materials & Methods

A prospective database has been maintained of all frames applied since 2007. Radiographs from frames applied prior to July 2022 were examined. Clinic letters were then used to identify complications.

Included: two ring hexapod for fracture, malunion, nonunion, arthrodesis or deformity correction in the lower limb.

Excluded: patients under 16 years old, diabetic feet, Charcot joints, soft tissue contractures, arthrodiastasis, correction of the mid/forefoot, plate fixation augmentation, fixation off a third ring.

Results

518 two ring hexapods were identified. Mean age was 46 (16–89). 55% were for fracture, 18% for malunion, 11% for nonunion. Mean frame time was 7 months (2–29 months).

All clinic letters from 384 patients showed 203 patients (52%) had at least one pin site infection, 27 nonunions (7%), 16 frame revisions (4%), 25 bone grafting procedures (7%), 5 cases of septic arthritis (1%), 3 periprosthetic fractures (0.8%),), 12 malunions (3%), 4 Amputations (1%).

Conclusions

These results demonstrate the efficacy of a two ring hexapod for patients requiring reconstruction of the lower limb.