Use of Ilizarov fixator Hexapod apparatus for fracture proximal tibia. Bone substitute Genex (Biocomposites) was used for this case.

1. Center for Limb Lengthening & Reconstruction, Mumbai
Hexapod Assisted Correction
Dr Mangal Parihar
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2. Center for Limb Lengthening & Reconstruction, Mumbai
Hexapod Assisted Fracture
Reduction
• 48 Year Male
• Vehicular Accident
• 2 weeks Post Injury
• Comminuted Compound
 TypeVI Schatzker Fracture
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3. Center for Limb Lengthening & Reconstruction, Mumbai
Preop Xrays
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4. Center for Limb Lengthening & Reconstruction, Mumbai
3D CT Pictures
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5. Center for Limb Lengthening & Reconstruction, Mumbai 5

6. Center for Limb Lengthening & Reconstruction, Mumbai
Problem List
• Wound
• Intra-articular Comminution
• Maintain vascularity of bone fragments
• Stable fixation
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7. Center for Limb Lengthening & Reconstruction, Mumbai
Steps
• Indirect Intra-articular Reduction
• Raft Screw
• Ilizarov Fixator Application
• Hexapod Assisted Correction
• Mobilization
• Wound Management
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8. Center for Limb Lengthening & Reconstruction, Mumbai
Carm Pictures of Intra-
articular reduction
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9. Center for Limb Lengthening & Reconstruction, Mumbai
Elevation of Depressed Lateral
Condyle
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10. Center for Limb Lengthening & Reconstruction, Mumbai 10

11. Center for Limb Lengthening & Reconstruction, Mumbai 11

12. Center for Limb Lengthening & Reconstruction, Mumbai
Reduction Achieved
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13. Center for Limb Lengthening & Reconstruction, Mumbai
Raft Screw
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14. Center for Limb Lengthening & Reconstruction, Mumbai
Genex Instillation
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15. Center for Limb Lengthening & Reconstruction, Mumbai
Ilizarov Fixator
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16. Center for Limb Lengthening & Reconstruction, Mumbai
Hexapod Calculations
• Distraction
• Angulation
• Anterior
Translation
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17. Center for Limb Lengthening & Reconstruction, Mumbai
Distraction
Lateral & Anterior Translation
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18. Center for Limb Lengthening & Reconstruction, Mumbai
10 Days
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Lateral & Anterior Translation
Compression

19. Center for Limb Lengthening & Reconstruction, Mumbai
12 Days
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20. Center for Limb Lengthening & Reconstruction, Mumbai 20

21. Center for Limb Lengthening & Reconstruction, Mumbai
Conversion To Straight Rods
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22. Center for Limb Lengthening & Reconstruction, Mumbai
2.5 Weeks Post Surgery
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23. Center for Limb Lengthening & Reconstruction, Mumbai
2.5 Weeks Post Surgery
• 3 wires in prox
fragment
• 1 wire and 1 schanz
screw in the middle
& distal ring
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24. Center for Limb Lengthening & Reconstruction, Mumbai

25. Center for Limb Lengthening & Reconstruction, Mumbai
Incisions
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26. Center for Limb Lengthening & Reconstruction, Mumbai
Evolution Of Wound Over 3
weeks
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27. Center for Limb Lengthening & Reconstruction, Mumbai
5 Months - AP
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28. Center for Limb Lengthening & Reconstruction, Mumbai
5 Months - Lat
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29. Center for Limb Lengthening & Reconstruction, Mumbai
Post Fixator Removal
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31. Center for Limb Lengthening & Reconstruction, Mumbai
Scars
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32. Center for Limb Lengthening & Reconstruction, Mumbai
Function
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33. Center for Limb Lengthening & Reconstruction, Mumbai
Function at 1 Year
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34. Center for Limb Lengthening & Reconstruction, Mumbai
Xrays At 1 Year
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35. Center for Limb Lengthening & Reconstruction, Mumbai
www.ilizarov.in
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