Zusammenfassung
Die Geschichte und die Entwicklung des Ringfixateurs ist eng mit der Geschichte der Beinverlängerung verbunden. Gavriil A. Ilizarov verdanken wir nicht nur seinen Ringfixateur, sondern auch die ersten wissenschaftlichen Untersuchungen zur Distraktionsosteogenese. Die Entwicklung und Verbreitung der Methode erfolgten zuerst durch einzelne Pioniere, eine standardisierte Nomenklatur und jährliche Kurse führten schließlich zu einer größeren Verbreitung. Ein Game-Changer war die Einführung des Taylor Spatial Frames (TSF) 1997. Obwohl schon zuvor unterschiedliche Gruppen Hexapoden-Fixateure entwickelt hatten, gelang es schließlich dem TSF eine entsprechende Marktreife und Marktpräsenz zu entwickeln. Nachdem das Patent für den TSF auslief, wurden von vielen Firmen Hexapoden-Fixateure mit unterschiedlichen Neuerungen entwickelt. Eine neue Version des TSF, der SMART TSF mit einer intuitiven Software-Planung wurde 2021 erstmals in Baltimore vorgestellt. Während die Einführung der Verlängerungsmarknägel zu Beginn der 2000er-Jahre und die weite Verbreitung ab etwa 2013 den Fixateur für einige Indikationen in den Hintergrund gestellt hat, ist dieser nach wie vor die Methode der Wahl für komplexere Rekonstruktionen, besonders bei Fehlstellungen in der Traumatologie sowie in der Kinderorthopädie bei offenen Wachstumsfugen.
Abstract
The history and development of circular fixation is closely aligned with the history of limb lengthening. Gavriil A. Ilizarov not only developed his circular fixator, but he also was the first to research and publish on distraction osteogenesis. Progress and dissemination of the method was initially based on individual pioneers; a standardized nomenclature and annual courses led to a wider dissemination. The introduction of the Taylor spatial frame in 1997 was a game changer. Although various groups had already developed Hexapod-fixators, it was the TSF that hit the market and achieved market presence. After the patent for TSF expired, many companies developed hexapod fixators with various modifications. A new version of the TSF, the Smart TSF, which included an intuitive planning software, was introduced in Baltimore in 2021. The introduction of intramedullary lengthening nails at the beginning of the 2000s and the wide dissemination starting approximately 2013 rendered external fixation obsolete for certain indications. However, ring fixators are still the method of choice for complex reconstruction of deformity in traumatology, as well as in pediatric orthopedics in the presence of open growth plates.
Abbreviations
- ACA:
-
„angular correction axis“
- AO :
-
Arbeitsgemeinschaft für Osteosynthesefragen
- ASAMI :
-
Associazione per lo Studio e l’Applicazione del Metodo di Ilizarov
- CORA :
-
„Center of rotation of angulation“
- TSF :
-
Taylor Spatial Frame
Literatur
Paley D (2018) The Ilizarov technology revolution: History of the discovery, dissemination, and technology transfer of the Ilizarov method. J Limb Lengthen Reconstr 4:115–128
Codivilla A (1905) On the means of lengthening, in the lower limb, the muscles and tissues which are shortened through deformity. Am J Orthop Surg 2:353–368
Ombrédanne L (1913) Allongement d’un fémur sur un membre trop court. Bull Mem Soc Chir Paris 39:1177–1180
Putti V (1921) The operative lengthening of the femur. JAMA 77:934–935
Wozasek GE, Radler C (1998) Externe Fixation in der Extremitätenverlängerung-Ein historischer Rückblick. Osteosynth Int 6:291–295
Pfeil J, Grill F, Graf R (1995) Extremitätenverlängerung, Deformitätenkorrektur, Pseudarthrosenbehandlung. Springer, Berlin, Heidelberg, S 1–5
Bosworth DM (1938) Skeletal distraction of the tibia. Surg Gynecol 66:912–924
Allan FG (1951) Leg-lengthening. Br Med J 1(4700):218–222
Anderson WV (1952) Leg lengthening. J Bone Joint Surg Br 34:150
Ilizarov GA (1992) Transosseous osteosynthesis-theoretical and clinical aspects of the regeneration and growth of tissue. Springer, Berlin, Heidelberg, New York
Aronson J, Harrison BH, Stewart CL, Harp JH Jr (1989) The histology of distraction osteogenesis using different external fixators. Clin Orthop Relat Res 241:106–116
Aronson J, Good B, Stewart C, Harrison B, Harp J (1990) Preliminary studies of mineralization during distraction osteogenesis. Clin Orthop Relat Res 250:43–49
Walker CW, Aronson J, Kaplan PA, Molpus WM, Seibert JJ (1991) Radiologic evaluation of limb-lengthening procedures. AJR Am J Roentgenol 156(2):353–358
Gavriel A, Golyakhovsky V (1988) Ilizarov: “the magician from Kurgan”. Bull Hosp Jt Dis Orthop Inst 48:12–16
Grill F (1984) Distraction of the epiphyseal cartilage as a method of limb lengthening. J Pediatr Orthop 4(1):105–108
Grill F, Franke J (1987) The Ilizarov distractor for the correction of relapsed or neglected clubfoot. J Bone Joint Surg Br 69(4):593–597
Wagner H (1971) Operative Beinverlängerung. Chirurgie 42:260–266
De Bastiani G, Aldegheri R, Renzi Brivio L, Trivella G (1986) Chondrodiatasis-controlled symmetrical distraction of the epiphyseal plate. Limb lengthening in children. J Bone Joint Surg Br 68(4):550–556
De Bastiani G, Aldegheri R, Renzi-Brivio L, Trivella G (1987) Limb lengthening by callus distraction (callotasis). J Pediatr Orthop 7(2):129–134
Green SA (1991) The Ilizarov method: rancho technique. Orthop Clin North Am 22(4):677–688
Green SA, Harris NL, Wall DM, Ishkanian J, Marinow H (1992) The rancho mounting technique for the Ilizarov method. A preliminary report. Clin Orthop Relat Res 280:104–116
Devyatov AA, Kamerin VK, Ilizarov GA (1980) Plastic reconstruction of longitudinal bone defects by means of compression and subsequent distraction. Acta Chir Plast 22(1):32–41
Ilizarov GA, Zusmanovitch FN, Markhashov AM, Khelimskii AM, Levitina LK, Azrapkin II (1980) Reconstruction of large defects of blood vessels on extremities by means of a gradual distraction. (an experimental study). Acta Chir Plast 22(3):156–165
Ilizarov GA (1988) The principles of the Ilizarov method. Bull Hosp Jt Dis Orthop Inst 48(1):1–11
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation. Clin Orthop Relat Res 238:249–281
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues: part II. The influence of the rate and frequency of distraction. Clin Orthop Relat Res 239:263–285
Ilizarov GA (1990) Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res 250:8–26
Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A (1994) Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am 25(3):425–465
Manner HM, Huebl M, Radler C, Ganger R, Petje G, Grill F (2007) Accuracy of complex lower-limb deformity correction with external fixation: a comparison of the Taylor spatial frame with the Ilizarov ring fixator. J Child Orthop 1(1):55–61
Gough VE, Whitehall SG (1962) Universal tire test machine. In: Proceedings of the FISITA Ninth International Technical Congress, S 117–137
Stewart D (1965) A platform with six degrees of freedom. Proc Instn Mech Eng 180:371–386
Ruggles DK (2018) History of the Taylor spatial frame and six-axis deformity correction. In: Herzenberg JE (Hrsg) The art of limb alignment: Taylor spatial frame. Rubin Institute for Advanced Orthopedics. Sinai Hospital of Baltimore, Baltimore
Paley D (2011) History and science behind the six-axis correction external fixation devices in orthopaedic surgery. Oper Tech Orthop 21:125–128
Seide K, Wolter D (1996) Universelle dreidimensionale Korrektur und Reposition mit dem Ringfixateur unter Anwendung der Hexapod-Anordnung. Unfallchirurg 99(6):422–424
Radler C (2018) Planning software. In: Herzenberg JE (Hrsg) The art of limb alignment: Taylor spatial frame. Rubin Institute for Advanced Orthopedics. Sinai Hospital of Baltimore, Baltimore
Eidelman M, Bialik V, Katzman A (2006) Correction of deformities in children using the Taylor spatial frame. J Pediatr Orthop B 15(6):387–395
Rozbruch SR, Pugsley JS, Fragomen AT, Ilizarov S (2008) Repair of tibial nonunions and bone defects with the Taylor spatial frame. J Orthop Trauma 22(2):88–95
Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR (2008) Limb salvage reconstruction of the ankle with fusion and simultaneous tibial lengthening using the Ilizarov/Taylor spatial frame. HSS J 4(1):32–42
Ganger R, Radler C, Speigner B, Grill F (2010) Correction of post-traumatic lower limb deformities using the Taylor spatial frame. Int Orthop 34(5):723–730
Rödl R, Leidinger B, Böhm A, Winkelmann W (2003) Deformitätenkorrektur mit Ringfixateuren und Hexapoden—Ein Methodenvergleich. Z Orthop Ihre Grenzgeb 141(1):92–98
Ferreira N, Birkholtz F (2015) Radiographic analysis of hexapod external fixators: fundamental differences between the Taylor spatial frame and trueLok-hex. J Med Eng Technol 39(3):173–176
Pesenti S, Iobst CA, Launay F (2017) Evaluation of the external fixator trueLok hexapod system for tibial deformity correction in children. Orthop Traumatol Surg Res 103(5):761–764
Gessmann J, Frieler S, Königshausen M, Schildhauer TA, Hanusrichter Y, Seybold D, Baecker H (2021) Accuracy of radiographic measurement techniques for the Taylor spatial frame mounting parameters. BMC Musculoskelet Disord 22(1):284
Messner J, Chhina H, Davidson S, Abad J, Cooper A (2021) Clinical outcomes in pediatric tibial lengthening and deformity correction: a comparison of the Taylor spatial frame with the orthex hexapod system. J Child Orthop 15(2):114–121
Gigi R, Mor J, Lidor I, Ovadia D, Segev E (2021) Auto strut: a novel smart robotic system for external fixation device for bone deformity correction, a preliminary experience. J Child Orthop 15(2):130–136
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C. Radler: Smith & Nephew Inc.: Consultant, Vortragshonorare, Kurse; Nuvasive Inc.: Vortrags-Honorare, Kurse; MD Orthopaedics Inc.: Consultant, Vortragshonorare; UNFO Med. Ltd.: Consultant.
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Radler, C. Externe Fixateure zur Korrektur komplexer Deformitäten. Orthopädie 52, 710–718 (2023). https://doi.org/10.1007/s00132-023-04419-w
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DOI: https://doi.org/10.1007/s00132-023-04419-w