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Arthroplast Today. 2017 Jun 9;4(2):192-199. doi: 10.1016/j.artd.2017.03.001. eCollection 2018 Jun.

Circular hexapod external fixation for periprosthetic tibial fracture.

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Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY, USA.
Department of Orthopaedic Surgery, Emek Medical Center, Afula, Israel.
Faculty of Medicine, Department of Orthopaedic Surgery, Technion, Haifa, Israel.


A poor soft tissue envelope often accompanies periprosthetic tibia fracture around a well-fixed total knee arthroplasty and the tibial stem leaves little room for screw fixation. This article describes the practicability and effectiveness of a novel surgical technique using circular hexapod external fixation, in patients with this clinical scenario. It was applied for fixation of periprosthetic tibia fracture in 2 patients. Contact between the external fixation pins and the prosthesis was avoided. Using a web-based software program, a gradual reduction in all planes was achieved. Adequate fixation, stability, reduction, and quick healing were obtained in the 2 cases, with minimal complications. The patients returned to their activity level a few months after external fixation removal.


Arthroplasty; External fixation; Gradual correction; Periprosthetic fracture; Taylor spatial frame; Total knee arthroplasty

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