重建矫形LRSNewClamps.pptVIP

The Orthofix Limb Reconstruction System: clamps for acute and gradual corrections. The Orthofix Limb Reconstruction System Monolateral rail: adult version Separate box for Paediatric LRS System Indications for the L.R.S: Shortening Deformity General Options for Deformity Correction Acute Correction with internal fixation with external fixation Gradual Correction during lengthening at the end of lengthening Acute or Gradual corrections with the LRS Basic Considerations Some important points to remember Axes: Preoperative planning is done using the mechanical and anatomical axes The mechanical axis is the most important axis to correct. Fixator placement: Translation may occur during correction, depending on the positioning of the fixator Effect of Position of the Hinge Important message!!!!! For gradual corrections, soft tissue tension must be released to allow for angular correction without damaging the clamp distractor. Never make a correction which involves new lengthening: tensions are too great Callus manipulation, not callus lengthening. Protocol for gradual correction: 1. Careful pre-operative planning: assess amount of lengthening or shortening that will occur during correction 2. Lengthen the amount required according to standard principles of Callotasis, at this stage without correcting deformity 3. Procedure then a little different according to whether fixator is on convex or concave side of deformity Fixator on Convex Side of Deformity When lengthening complete, rest patient on bed Shorten acutely by 4 - 5 mm Make correction with distractor of clamp until it becomes a little stiff Repeat above two steps until correction complete Fixator on Concave Side of Deformity When lengthening complete, rest patient on bed Because correction will shorten bone, correction can now be done with the clamp distractor in one stage Summary Lengthening by Callotasis is always required before gradual correction Achieved by standard com