Overview

Acute Deformity Correction is used to reposition the bones into normal alignment to improve function and prevent future problems with the body and joints. During this type of surgery there are two different techniques that can be used: Fixator assisted plating (FAP) or Fixator assisted Nailing (FAN). Both techniques cut the bone into two separate segments and then with the help of external fixation, the segments are placed into normal alignment (made straight). Once the correct alignment is achieved, internal fixation (a plate or nail) is then used to keep it fixed and the external fixator is removed. With Acute Deformity Correction the bony alignment is usually set during a single surgery. Patients benefit from follow up appointments that ensure proper healing of the bone and function of the surrounding joints.

Indications / Candidacy

Different types of acute deformity correction can be performed in both pediatric and adult patients. Candidates will be assessed by one of our surgical specialists to ensure a proper diagnosis and that all physical criteria are met. Patients, and in some cases their care givers, must be willing to participate in physical therapy, and attend regular appointments with their physician. Good candidates for this procedure would benefit from deformity correction as a means to improve their quality of life and physical functioning.

Good candidates for acute deformity correction procedures, typically have:

  • Smaller deformities
  • Deformities in which there is no risk to the neurovascular structures or soft tissues
  • Single or multiplanar deformities
  • Limb deformity involving a small (under 1cm) limb length discrepancy
  • Usually done in patients with closed growth plates (but in some cases can be done in children)

Treated Conditions

The Canadian Limb Lengthening Center offers treatment of many complex orthopedic conditions. We pride ourselves in providing highly specialized expert care and the most up to date equipment and technologies. Using a holistic approach to acute deformity correction, we help patients treat many of the following conditions:

Condition

Acquired Deformity

Condition

Charcot foot

Condition

Genu valgum

Condition

Genu varum

Condition

Hindfoot arthritis and deformity

Condition

Mal-union

Condition

Non-union and infected non-unions

Condition

Other Deformity and LLD

Condition

Rotational deformities

Condition

Skeletal dysplasias

Surgical Technique

FAN (fixator assisted nailing)

  • Temporary external fixator pins are placed on the leg
    or deformed bone
  • The bone is then broken (osteotomized) at the location of correction through a small incision
  • The external fixator is then used to correct the deformity
  • The accuracy of the correction is assessed using x-rays and measurements in the operating room
  • Once the correction is achieved, the nail is then inserted and locked
  • The external fixator is then removed
  • The patient never sees this device, it is simply used to aid in correcting the limb deformity during surgery and the patient does not have it upon waking in the recovery room
  • The skin is closed, and the patient is brought to the recovery room

FAP (fixator assisted plating)

This is the same technique as FAN, but instead of using a nail as the final fixation, we use a plate.

Advantages of fixator assisted techniques (FAN and FAP):

  • Improved accuracy of deformity correction (compared to non-fixator assisted techniques)
  • X-ray verification of bone alignment during operation
  • Ensures proper rotation of the bone during fixation
  • Very small incisions
  • The patient never has to see or endure the external fixator as it is removed in the operating room prior to waking

Results

With increased function (better walking/gait) and improved muscle strength our patients typically live very active, healthy lives after acute deformity correction. For some patients, deformity correction can decrease pain and discomfort while providing the psychological benefits of having a more positive body image and body function. The other great advantage of deformity correction is preventing premature wear and tear of the joints (due to poor limb and joint alignment). A large part of patient success relies on having a team of experienced surgeons, support staff and physical therapists that provide a comprehensive surgical program.

ACUTE CORRECTION WITH FIXATOR ASSISTED NAILING (FAN)

ACUTE CORRECTION WITH FIXATOR ASSISTED PLATING (FAP)

Potential Complications

As with any surgical procedure, Acute Deformity Correction can have difficulties and complications. We take extensive measures to avoid complications and have experienced specialist who know how to respond in cases where difficulties arise. Complications and side effects may include:

  • Delayed union, non-union or malunion of the bone
  • Superficial (skin and soft tissues) or deep infection (bone infection)
  • Neurovascular injury (very rare)
  • Compartment syndrome (very rare)
  • Other surgery related complications that can occur but remain rare (Deep vein thrombosis, cardiac or pulmonary issues or pulmonary embolism)

Pre-Operative Care

  • An extensive medical history will be taken during your initial assessments
  • It is recommended that you stay active, eat a healthy diet, and stop smoking prior to any operation
  • Certain medications and vitamins may need to be stopped several weeks before
  • Discuss all medications and over the counter drugs with your surgeon
  • Use a calendar or agenda to organize your pre and post appointment dates
  • Make arrangements for personal care givers

Post-Operative Care

  • Immediately after surgery, patients are allowed toe touch weight bearing on the operated leg with the use of crutches or a walker
  • Patients can expect to be hospitalized for about 24hrs after the surgery
  • The dressings are changed in the hospital on post-operative day 1 or 2 and then kept until the first clinic visit

Patients who will undergo this procedure should read Immediate post-operative care.

Follow-ups after surgery

  • Patients will be required to attend all post-operative appointments
  • The first follow up visit will be 7-10 days after surgery to check the incisions and remove the dressings.
  • Generally, the clinic visits and x-ray follow up are then at 6 weeks, 3 months and 6 months post-operatively
  • Physiotherapy session will focus on mobilisations of the joints above and below where the bone was broken and must begin immediately
  • Total weight bearing can generally be initiated after the 6 weeks follow-up appointment or as instructed by your surgical team.

Case studies

13 year old girl with rickets (underlying bone problem)
35 yr old woman with leg deformity (knocked knee)

AM I A CANDIDATE?

Are you experiencing an orthopedic condition and would like to improve your physical capabilities?

Or you simply would like to achieve your long-lasting dream of improving your height?

Let us help you achieve your optimal health and wellness in a professional setting.

Let’s open up a discussion to help you achieve your goals.

Highly specialized expert care at CLLC

At the Canadian Limb Lengthening Centre we offer complex deformity correction and limb lengthening surgeries performed by experienced surgeons with the most up to date technologies. When it comes to your care, and treatment of deformity and limb length discrepancy, our surgeons have extensive training and experience.

LW