Reconstructing Limb Deformities using the VCAM TM External Fixator: A series of 3 cases

摘要

External fixation was used almost exclusively for fracture management. It is also used for arthrodesis, management of lower extremity deformities such as Charcot neuroarthropathy, limb lengthening, osteotomy stabilization, osteomyelitis, nonunion or pseudoarthrosis. It has proven extremely useful in the treatment of a number of conditions because it can provide distraction, compression, stabilization and neutralization as needed. Traditional external fixators involve driving pins through the tibia and fibula. The VCAM? is a unique below the ankle external fixator. The VCAM? can avoid possible disruptions and complications that are often seen with traditional Ilizarov fixators. The indications for the VCAM? external fixator are identical to the Ilizarov fixators, such as off-loading, fracture reduction and reconstructive procedures. In our institution, we have used the VCAM? device to off-load ulcerations and correct limb deformities. In the cases presented in this paper the VCAM? was used to off-load wounds secondary to Charcot arthropathy and transmetatarsal amputations, as well as to gradually correct a rearfoot deformity such as seen in a Chopart's amputation. The VCAM? can be constructed into an Ilizarov type frame or a hybrid frame which can be used to achieve gradual triplanar correction. We have seen good results using the VCAM? for wound care and limb deformities and recommend this approach when tibia and fibula intervention is not necessary.