The correction of complex multiplanar deformities using the Ilizarov fixator often requires its joints and component parts to be replaced between 3 and 5 times in order to achieve the final outcome. Every stage in the change of a unit’s installation is a somewhat laborious process, increasing a patient’s exposure to radiation and it requires frequent X-ray examinations.
The problem in managing the position of the object within a three-dimensional space calls for cutting edge technical solutions. A new direction in the development of this sector is the application of external hexapod fixators. The hexapod is a structure that consists of two levels of fixation of the bone fragments, linked by a system of 6 telescopic rods (referred to as “layers”). There are different models of hexapod, which differ in the design of the connecting rods and the platforms.
By changing the length of even a single rod on the hexapod, a platform moves, with respect to the others, in three dimensions. To control and direct the movement of the platform therefore requires the use of a computer. When applied to orthopaedics, the “hexapod” can be considered a universal system of reduction that allows a ring to be moved with a shorter trajectory.
The first hexapod fixators were developed in the United States and Germany. The Taylor Spatial Frame (TSF) unit – which was first used in 1994 (JC Taylor, 1997) – and the Ilizarov Hexapod System (IHS) unit – which was developed in 1999 (Seide K. et al., 1999). In 2006, Russia developed an original transosseous hexapod: the Ortho-SUV unit. The ability to perform an accurate mathematical correction of the deformity without the need to replace the fixator has rendered these devices increasingly popular in the treatment of fractures and in the corrections of complex, long bone deformities (D. Paley, 2005 ;. Seide K. et al, 2008; Solomin LN et al, 2009).
Ellipse Technologies Inc. has developed the most compact device in use today, for the intramedullary elongation of limbs. The device, the PRECICE 8.5 mm provides a minimally invasive surgical solution for patients with small intramedullary canals. This state-of-the-art device is an extension of the Ellipse technology that uses a remote controlled system for elongating the leg in a non-invasive way. The PRECICE 8.5 mm device is an alternative to external fixation for elongating both femurs and tibias.
THE ADVANTAGES OF PRECICE
Customisable elongation procedure; non invasive distraction via an external remote control system; options for the patient’s preferred treatment; cutting-edge magnetic technology; up to 80 mm of distraction; the device can be reversed.
The key to the success of the Ellipse technology is the magnetic interaction between the PRECISE (IM) intramedullary device and the remote control unit. The technology includes a complex internal mechanism activated and controlled by permanent magnets. This innovation in the elongation of limbs allows a controlled distraction phase with the benefit of a non-invasive procedure.
CHARACTERISTICS OF THE PRECICE 8.5
It offers a full range of units for treating the difference in bone length of the tibia and the femur.