Building
a Sheffield Ring Fixator Construct for a deformity correction
The
problem: a lower third tibial malunion at two levels from
two separate fractures.
The solution: an oblique plane correction
at the lower level, lengthening, derotation and finally correction of
residual translation.
The oblique plane is deformity is measured to be 18 degrees (16 degrees
valgus and 8 degrees anterior angulation) 7 cm from the ankle joint.
The
ring is laid over the tracing with the front of the ring anterior on
the tracing to identify the position of the motor and hinges). Rotation
translation hinges are selected to facilitate subsequent corrective
stages. Since
the ring is 15mm thick, its lower most wire 2mm below this and positioned
5mm above the joint the hinge is placed 48mm above the ring.
The
second hinge is applied at the same height and correct orientation confirmed
by placing a 2mm wire through the cannulation of the two hinges.
Three
long threaded bars are inserted tempoarily in holes that will not be
used and a second ring is mounted using the same holes.
The hinges are locked and a
motor built from two hinge clamps applied
at right angles to the hinges.
The temporary bars are removed, the hinges unlocked, and smooth movement
of the frame confirmed from the deformed
to the corrected
position.
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