Accuracy and Efficacy of Software-guided Bony Realignment in Periarticular Deformities of the Lower Limb

Abstract

Aim and objective: Software-guided realignment is proposed as an easy and accurate method of achieving simultaneous multiaxial correction. The accuracy and efficacy in periarticular problems have not been investigated fully. This study investigates the results and possible clinical benefits.

Materials and methods: A retrospective review was performed in 24 patients with 27 periarticular deformities of the lower limb treated by the Ilizarov technique. Bony realignment was achieved by a software-guided hexapod realignment device. The deformity category, deformity severity score (DSS) and individual deformity component scores were measured for objective quantification of each deformity. The periarticular level, number of manoeuvres, correction period and any difficulties in the execution of the correction manoeuvre were noted. Pre-procedure and post-procedure values of deformity parameters were analysed to estimate the accuracy and efficacy of the realignment device.

Results: The correction manoeuvre was accomplished successfully in all patients except two. The mean correction period was 14.9 days (range, 5-38 days). The mean pre-procedure DSS was 18.7 (range 6.3-27.3), which reduced to a mean post-procedure value of 1.5 (range, 0-7.9) with a 92.0% deformity correction (p-value < 0.001)). There was a significant reversal of individual deformity components. DSS values were achieved to an excellent level (< 3.5) in 25 deformities and to good and poor levels in one deformity, respectively.

Conclusion: Software-guided realignments are effective for accurate realignment of periarticular deformities using Ilizarov fixators. These devices offer simultaneous multidimensional corrections even in complex multiplanar deformities and simplify the task of deformity correction.

Clinical significance: The present study assesses the accuracy and efficacy of software-guided realignments using novel concepts of deformity category, DSS and individual deformity component scores, which may overcome some of the shortcomings of conventional assessment methods.

How to cite this article: Singh P, Sabat D, Dutt S, et al. Accuracy and Efficacy of Software-guided Bony Realignment in Periarticular Deformities of the Lower Limb. Strategies Trauma Limb Reconstr 2021;16(2):65-70.

Keywords: Deformity severity score; Ilizarov fixator; Ortho-SUV frame; Periarticular deformities; Software-guided bony realignments.