Foot Deformity Correction with Hexapod External Fixator, the Ortho-SUV Frame™

Abstract

External fixators enable distraction osteogenesis and gradual foot deformity corrections. Hexapod fixators have become more popular than the Ilizarov apparatus. The Ortho-SUV Frame™ (OSF; Ortho-SUV Ltd, St. Petersburg, Russia), a hexapod that was developed in 2006, allows flexible joint attachment such that multiple assemblies are available. We assessed the reduction capability of several assemblies. An artificial bone model with a 270-mm-long longitudinal foot was used. A 130-mm tibial full ring was attached 60 mm proximal to the ankle joint. A 140-mm, two-third ring forefoot was attached perpendicular to the metatarsal bone axis. A 130-mm, two-third ring hindfoot was attached parallel to the tibial ring. A V-osteotomy, which was combined with 2 oblique osteotomies at the navicular–cuboid bone and the calcaneus, was performed. The middle part of the foot, including the talus, was connected to the tibial ring. We assessed 5 types of forefoot applications and 4 types of hindfoot applications. The range of correction included flexion/extension in the sagittal plane, adduction/abduction in the horizontal plane, and pronation/supination in the coronal plane. Additionally, we reported the short-term results in 9 clinical cases. The forefoot applications in which the axis of the hexapod was parallel to the axis of the metatarsal bones had good results, with 52°/76° for flexion/extension, 48°/53° for adduction/abduction, and 43°/51° for pronation/supination. The hindfoot applications in which the hexapod encircled the ankle joint also had good results, with corresponding values of 47°/58°, 20°/35°, and 28°/31°. Clinically, all deformities were corrected as planned. Thus, multiple assemblies and a wide range of corrections are available with the OSF.