Correction of Multiapical Deformities of Long Bones of the Lower Extremities: A Review

Abstract

Background. Multiapical deformities of the long bones of the lower extremities represent a complex and widely prevalent orthopedic pathology. A numerous of publications address its individual aspects: diagnosis, planning, and correction. However, no single study was found that offers a comprehensive assessment of contemporary views on treating patients with multiapical deformities of long bones.

Aim of the review — to define current concepts and unresolved issues in the analysis, planning, and correction of multiapical deformities of the long bones of the lower limbs based on the scientific literature.

Methods. Electronic databases were utilized for literature search: PubMed/MEDLINE, SAGE Publishing Journals, Embase, eLIBRARY, Google Scholar. Particular attention was paid to studies that provide information on diagnosis, planning, and correction methods for multiapical deformities. A total of 46 publications were included in the review.

Results. In the literature, the terms “multiapical deformity” and “multilevel deformity” are used synonymously. At the same time, the term “multilevel deformity” is used to denote uniapical deformities of different limb segments. The main diagnostic feature of a multiapical deformity is the location of the apex outside the bone. Unlike uniapical deformities, the correction planning of multiapical deformities uses the axis of the intermediate fragment(s). Most authors define it as the mid-diaphyseal line. The correction of multiapical deformities is performed either acute or gradually. Acute correction with internal fixation is undoubtedly more comfortable for the patient. If there are contraindications to it, the deformity correction is performed gradually using Ilizarov hinges or orthopedic hexapods.

Conclusion. The term “multiapical deformity” inherently indicates that the deformed bone has more than one apex, so it should take precedence over the term “multilevel deformity”. The diagnostic feature of the multiapical deformity “localization of the AOD outside the bone” is not absolute and requires clarification. There are challenges in planning the correction using mechanical axes, as well as in determining the axis of the nonlinear (bowing) intermediate fragment(s). The “spring technique” has significant advantages over other variants of using orthopedic hexapods in correcting a multiapical deformity. However, a rationale for the optimal characteristics of springs, their fixation points to supports, and clarification of the computer program’s use method is required. Addressing these issues will enhance the treatment efficiency for patients with multiapical deformities.

Keywords

multiapical deformities / multilevel deformities / deformity correction planning / acute deformity correction / gradual deformity correction / assisted external fixation / external fixation / orthopedic hexapod / spring technique

References

[1] Paley D. Principles of deformity correction. New York: Springer-Verlag; 2009. p. 61-154.

[2] Paley D. Principles of deformity correction. / D. Paley. – New York: Springer-Verlag, 2009. – pp. 61-99; pp. 99-154.

[3] Соломин Л.Н. Основы чрескостного остеосинтеза при деформациях длинных костей. В кн.: Основы чрескостного остеосинтеза. Под ред. Л.Н. Соломина. Москва: БИНОМ; 2015. Т. 2. с. 590-735. Solomin L.N. Basic Principles of Correction of Long-Bone Deformities. In: The Basic Principles of External Skeletal Fixation. Solomin L.N. (ed.). Moscow: BINOM; 2015. Vol. 2. p. 590-735. (In Russian).

[4] Соломин Л.Н. Основы чрескостного остеосинтеза при деформациях длинных костей. Основы чрескостного остеосинтеза / Под ред. Л.Н. Соломина.-М.: Издательство БИНОМ, 2015.-Т.2.-2-е издание, переработанное и дополненное. стр. 590-735

[5] Schröter S., Elson D.W., Ateschrang A., Ihle C., Stöckle U., Dickschas J. et al. Lower Limb Deformity Analysis and the Planning of an Osteotomy. J Knee Surg. 2017; 30(5):393-408. doi: 10.1055/s-0037-1603503.

[6] Solomin L.N. Basic Principles of Correction of Long-Bone Deformities. The Basic Principles of External Skeletal Fixation/ Solomin L.N. (ed.). BINOM, 2015. II v.-2nd edition. pp. 590-735 (In Russ.)

[7] Зырянов С.Я. Одновременное устранение деформаций всех сегментов нижней конечности. Гений ортопедии. 1995;(1):53-58. Zyryanov S.Ya. Simultaneous deformity correction of all segments of the lower limb. Genij ortopedii. 1995;(1): 53-58. (In Russian).

[8] Schröter. S., Elson, D. W., Ateschrang, A., Ihle, C., Stöckle, U., Dickschas, J., Harrer, J. Lower limb deformity analysis and the planning of an osteotomy //The Journal of Knee Surgery. – 2017. – Т. 30. – №. 05. – С. 393-408. https://doi:10.1055/s-0037-1603503

[9] Шевцов В.И., Шрейнер А.А., Смелышев К.Н., Свешников А.А., Обанина Н.Ф. Рентгенологическая картина и плотность минеральных веществ в костях голени на этапах коррекции двухуровневых деформаций аппаратом Илизарова. Гений ортопедии. 2000;(1):60-64. Shevtsov V.I., Shreiner A.A., Smelyshev K.N., Sveshnikov A.A., Obanina N.F. Roentgenologic patterns and mineral density in leg bones at the stages of correction of their two-level deformities with the Ilizarov apparatus. Genij Ortopedii. 2000;(1):60-64. (In Russian).

[10] Зырянов С. Я. Одновременное устранение деформаций всех сегментов нижней конечности //Гений ортопедии. – 1995. – №. 1. – С. 53-58.

[11] Paley D., Herzenberg J.E., Tetsworth K., McKie J., Bhave A. Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am. 1994;25(3):425-65.

[12] Zyrjanov S. Ja. [Simultaneous deformity correction of all segments of the lower limb] Genij ortopedii [Orthopaedic genius] – 1995. – №. 1. – С. 53-58. (In Russ.)

[13] Matsubara H., Tsuchiya H., Sakurakichi K., Watanabe K., Tomita K. Deformity correction and lengthening of lower legs with an external fixator. Int Orthop. 2006;30(6):550-554. doi: 10.1007/s00264-006-0133-8.

[14] Шевцов, В. И., Шрейнер, А. А., Смелышев, К. Н., Свешников, А. А., Обанина, Н. Ф. Рентгенологическая картина и плотность минеральных веществ в костях голени на этапах коррекции двухуровневых деформаций аппаратом Илизарова //Гений ортопедии. – 2000. – №. 1. – С. 60-64.

[15] Ganger R., Radler C., Speigner B., Grill F. Correction of post-traumatic lower limb deformities using the Taylor spatial frame. Int Orthop. 2010;34(5):723-730. doi: 10.1007/s00264-009-0839-5.

[16] Shevtsov V.I., Shreiner A.A., Smelyshev K.N., Sveshnikov A.A., Obanina N.F. [Roentgenologic patterns and mineral density in leg bones at the stages of correction of their two-level deformities with the Ilizarov apparatus] Genij ortopedii [Orthopaedic genius] – 2000. – №. 1. – С. 60-64. (In Russ.)

[17] Brinker M.R., O’Connor D.P. Principles of malunions. In: Rockwood Green’s fractures in adults. Philadelphia: Wolters Kluwer Health, 2015. p. 869-894.

[18] Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A. Deformity planning for frontal and sagittal plane corrective osteotomies //Orthopedic Clinics of North America. – 1994. – Т. 25. – №. 3. – С. 425-466.

[19] Çakmak M., Cıvan M. Multiapical Deformities. In.: Basic Techniques for Extremity Reconstruction. Cham: Springer, 2018. р. 285-294.

[20] Matsubara, H., Tsuchiya, H., Sakurakichi, K., Watanabe, K., & Tomita, K. Deformity correction and lengthening of lower legs with an external fixator //International orthopaedics. – 2006. – Т. 30. – №. 6. – С. 550-554. https://doi:10.1007/s00264-006-0133-8

[21] Massobrio M., Mora R. (ed.). Hexapod External Fixator Systems: Principles and Current Practice in Orthopaedic Surgery. Springer International Publishing; 2021. p. 61-65; p. 133-152.

[22] Ganger, R., Radler, C., Speigner, B., Grill, F. Correction of post-traumatic lower limb deformities using the Taylor spatial frame //International orthopaedics. – 2010. – Т. 34. – №. 5. – С. 723-730. https://doi:10.1007/s00264-009-0839-5

[23] Paley D., Tetsworth K. Mechanical axis deviation of the lower limbs. Preoperative planning of multiapical frontal plane angular and bowing deformities of the femur and tibia. Clin Orthop Relat Res. 1992;(280):65-71.

[24] Brinker M. R., O’Connor D. P. Principles of malunions //Rockwood Green’s fractures in adults. 8th ed. Philadelphia: Wolters Kluwer Health. – 2015. – pp. 869-894.

[25] Tetsworth K.D., Paley D. Accuracy of correction of complex lower-extremity deformities by the Ilizarov method. Clin Orthop Relat Res. 1994;(301):102-110.

[26] 10. Çakmak M., Cıvan M. Multiapical Deformities //Basic Techniques for Extremity Reconstruction. – Springer, Cham, 2018. – С. 285-294.

[27] Standard S.C., Herzenberg J.E., Conway J.D., Siddiqui N.A., McClure P.K. The Art of Limb Alignment. Baltimore: Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore; 2019. p. 77-135.

[28] Massobrio M., Mora R. (ed.). Hexapod External Fixator Systems: Principles and Current Practice in Orthopaedic Surgery. – Springer International Publishing, 2021. pp. 61-65; pp. 133-152.

[29] Heijens E., Gladbach B., Pfeil J. Definition, Quantification, and Correction of Translation Deformities Using Long Leg, Frontal Plane Radiography. J Pediatric Orthop. Part B. 1999;8(4):285-291. doi: 10.1097/01202412-199910000-00011.

[30] Paley D., Tetsworth K. Mechanical axis deviation of the lower limbs. Preoperative planning of multiapical frontal plane angular and bowing deformities of the femur and tibia //Clinical Orthopaedics and Related Research. – 1992. – №. 280. – С. 65-71. https://doi:10.1097/00003086-199207000-00009

[31] Seide K., Faschingbauer M., Wenzl M.E., Weinrich N., Juergens C. A hexapod robot external fixator for computer assisted fracture reduction and deformity correction. Int J Med Robot. 2004;1(1):64-69. doi: 10.1002/rcs.6.

[32] Tetsworth K. D., Paley D. Accuracy of correction of complex lower-extremity deformities by the Ilizarov method //Clinical Orthopaedics and Related Research®. – 1994. – Т. 301. – С. 102-110. https://doi:10.1097/00003086-199404000-00017

[33] Bilen F.E., Kocaoglu M., Eralp L., Balci H.I. Fixator-assisted nailing and consecutive lengthening over an intramedullary nail for the correction of tibial deformity. J Bone Joint Surg Br. 2010;92(1):146-152. doi: 10.1302/0301-620X.92B1.22637.

[34] Standard SC, Herzenberg JE, Conway JD, Siddiqui NA, McClure PK. The Art of Limb Alignment. Baltimore //Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore. – 2019. pp. 77-103; pp. 103-135.

[35] Galal S. Comparison of Fixator Assisted Plating versus Fixator Assisted Nailing for Distal Femoral Osteotomy. J Limb Length Reconstr. 2017;3(1):52-56.

[36] Heijens E., Gladbach B., Pfeil J. Heijens. Definition, Quantification, and Correction of Translation Deformities Using Long Leg, Frontal Plane Radiography. //Journal of Pediatric orthopedics. Part B. – 1999. – Т. 8. – №. 4. – С. 285-291. https://doi:10.1097/01202412-199910000-00011

[37] Tsuchiya H., Uehara K., Abdel-Wanis M.E., Sakurakichi K., Kabata T., Tomita K. Deformity correction followed by lengthening with the Ilizarov method. Clin Orthop Relat Res. 2002;(402):176-183. doi: 10.1097/00003086-200209000-00016.

[38] Bilen, F. E., Kocaoglu, M., Eralp, L., Balci, H. I. (2010). Fixator-assisted nailing and consecutive lengthening over an intramedullary nail for the correction of tibial deformity //The Journal of Bone and Joint Surgery. British volume. – 2010. – Т. 92. – №. 1. – С. 146-152. https://doi:10.1302/0301-620x.92b1.22637

[39] Соломин Л.Н., Щепкина Е.А., Корчагин К.Л., Сабиров Ф.К., Таката М., Цучия Х. Новый способ коррекции многоуровневых деформаций длинных костей с использованием ортопедического гексапода. Травматология и ортопедия России. 2017;23(3):103-109. Solomin L.N., Shchepkina E.A., Korchagin K.L., Sabirov F.K., Takata M., Tsuchia Kh. The New Method of Long Bone Multilevel Deformities Correction Using the Orthopedic Hexapod (Preliminary Report). Traumatology and Orthopedics of Russia. 2017;23(3):103-109. (In Russian).

[40] Galal S. Comparison of fixator-assisted plating versus fixator-assisted nailing for distal femoral osteotomy //Journal of Limb Lengthening & Reconstruction. – 2017. – Т. 3. – №. 1. – С. 52. https:// 10.4103/jllr.jllr_25_16

[41] Виленский В.А., Захарьян Е.А., Зубаиров Т.Ф., Долгиев Б.Х., Толдиева Х.Б., Фомылина О.А. Лечение двухуровневых деформаций костей голени: два гексапода или один? Современные проблемы науки и образования. 2019;(96):141-141. doi: 10.17513/spno.29352. Режим доступа: https://science-education.ru/ru/article/view?id=29352. Vilensky V.A., Zakharyan E.A., Zubairov T.F., Dolgiev B.Kh., Toldieva Kh.B., Fomylina O.A. Treatment of two-level deformities of lower leg bones: two hexapods or one? Modern Problems of Science and Education. Surgery. 2019;(6):141-141. doi: 10.17513/spno.29352. Available from: https://science-education.ru/ru/article/view?id=29352. (In Russian).

[42] Tsuchiya, H., Uehara, K., Abdel-Wanis, M. E., Sakurakichi, K., Kabata, T., Tomita, K. Deformity correction followed by lengthening with the Ilizarov method //Clinical Orthopaedics and Related Research®. – 2002. – Т. 402. – С. 176-183. https://doi:10.1097/00003086-200209000-00016

[43] Лунева С.Н., Смелышев К.Н., Ерофеева Т.Н., Десятниченко К.С. Пролиферативная и экспрессивная активности клеток суставного хряща при устранении деформации голени в эксперименте. Гений ортопедии. 2000;(4):15-18. Luniova S.N., Smelyshev K.N., Yerofeyeva T.N., Desiatnichenko K.S. Proliferative and expressive activities of articular cartilage cells during experimental correction of leg deformity. Genij Ortopedii. 2000;(4):15-18. (In Russian).

[44] Соломин, Л. Н., Щепкина, Е. А., Корчагин, К. Л., Сабиров, Ф. К., Таката, М., Цучия, Х. Новый способ коррекции многоуровневых деформаций длинных костей с использованием ортопедического гексапода //Травматология и ортопедия России. – 2017. – Т. 23. – №. 3. – С. 103-109. УДК 616.71-007.24-089.84

[45] Nicol S., Jackson M., Monsell F. Recent advances in external fixation. Bone Joint 360. 2015;4(4):2-7. doi: 10.1302/2048-0105.42.360352.

[46] Solomin L.N., Shchepkina E.A., Korchagin K.L., Sabirov F.K., Takata M. [The New Method of Long Bone Multilevel Deformities Correction Using the Orthopedic Hexapod (Preliminary Report)] Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia] – 2017. – Т. 23. – №. 3. – С. 103-109. (In Russ.)

[47] Kocaoğlu M., Tsuchiya H., Eralp L. (ed.). Femoral and Tibial Deformity Correction and Consecutive Lengthening over an Intramedullary Nail (FAN-LON). In: Advanced techniques in limb reconstruction surgery. Springer; 2015. p. 49-85.

[48] Виленский, В. А., Захарьян, Е. А., Зубаиров, Т. Ф., Долгиев, Б. Х., Толдиева, Х. Б., Фомылина, О. А. Лечение двухуровневых деформаций костей голени: два гексапода или один? //Современные проблемы науки и образования. – 2019. – №. 6. – С. 141-141. УДК 617.584-089.844

[49] Trombetti A., Al-Daghri N., Brandi M.L., Cannata- Andía J.B., Cavalier E., Chandran M. et al. Interdisciplinary management of FGF23-related phosphate wasting syndromes: a Consensus Statement on the evaluation, diagnosis and care of patients with X-linked hypophosphataemia. Nat Rev Endocrinol. 2022;18(6):366-384. doi: 10.1038/s41574-022-00662-x.

[50] Vilensky V.A., Zakharyan E.A., Zubairov T.F., Dolgiev B.Kh., Toldieva Kh.B., Fomylina O.A. [Treatment of two-level deformities of lower leg bones: two hexapods or one?] Sovremennye problemy nauki i obrazovanija [Modern Problems of Science and Education. Surgery]. – 2019. – №. 6. – С. 141-141. (In Russ.)

[51] Paley D., Herzenberg J.E., Bor N. Fixator-assisted nailing of femoral and tibial deformities. Tech Orthop. 1997; 12(4):260-275. doi: 10.1097/00013611-199712000-00004.

[52] Лунева, С. Н., Смелышев, К. Н., Ерофеева, Т. Н., Десятниченко, К. С. Пролиферативная и экспрессивная активности клеток суставного хряща при устранении деформации голени в эксперименте //Гений ортопедии. – 2000. – №. 4. – С. 15-18.

[53] Eralp L., Kocaoglu M., Cakmak M., Ozden V.E. A correction of windswept deformity by fixator assisted nailing. A report of two cases. J Bone Joint Surg Br. 2004; 86(7):1065-1068. doi: 10.1302/0301-620x.86b7.14923.

[54] Luniova S.N., Smelyshev K.N., Yerofeyeva T.N., Desiatnichenko K.S. [Proliferative and expressive activities of articular cartilage cells during experimental correction of leg deformity] Genij ortopedii [Orthopaedic genius] – 2000. – №. 4. – С. 15-18. (In Russ.)

[55] Song H.R., Soma Raju V.V., Kumar S., Lee S.H., Suh S.W., Kim J.R. et al. Deformity correction by external fixation and/or intramedullary nailing in hypophosphatemic rickets. Acta Orthop. 2006;77(2):307-314. doi: 10.1080/17453670610046073.

[56] Nicol S., Jackson M., Monsell F. Recent advances in external fixation //Bone & Joint 360. – 2015. – Т. 4. – №. 4. – С. 2-7. https:// 2–7. doi:10.1302/2048-0105.42.360352

[57] Eralp L., Kocaoglu M., Toker B., Balcı H.I., Awad A. Comparison of fixator-assisted nailing versus circular external fixator for bone realignment of lower extremity angular deformities in rickets disease. Arch Orthop Trauma Surg. 2011;131(5):581-589. doi: 10.1007/s00402-010-1162-8.

[58] Kocaoğlu M., Tsuchiya H., Eralp L. (ed.). Femoral and Tibial Deformity Correction and Consecutive Lengthening over an Intramedullary Nail (FAN-LON). Advanced techniques in limb reconstruction surgery. – Springer, 2015. pp. 49-85

[59] Kocaoğlu M., Bilen F.E., Sen C., Eralp L., Balci H.I. Combined technique for the correction of lower-limb deformities resulting from metabolic bone disease. J Bone Joint Surg Br. 2011;93(1):52-56. doi: 10.1302/0301-620X.93B1.24788.

[60] Trombetti, A., Al-Daghri, N., Brandi, M. L., Cannata-Andía, J. B., Cavalier, E., Chandran, M., Rizzoli, R. Interdisciplinary management of FGF23-related phosphate wasting syndromes: a consensus statement on the evaluation, diagnosis and care of patients with X-linked hypophosphataemia //Nature Reviews Endocrinology. – 2022. – Т. 18. – №. 6. – С. 366-384.

[61] Hughes A., Heidari N., Mitchell S., Livingstone J., Jackson M., Atkins R. et al. Computer hexapod-assisted orthopaedic surgery provides a predictable and safe method of femoral deformity correction. Bone Joint J. 2017;99-B(2):283-288. doi: 10.1302/0301-620X.99B2.BJJ-2016-0271.R1.

[62] Paley D., Herzenberg J. E., Bor N. Fixator-assisted nailing of femoral and tibial deformities //Techniques in Orthopaedics. – 1997. – Т. 12. – №. 4. – С. 260-275. https://doi:10.1097/00013611-199712000-00004

[63] Vaidya S.V., Song H.R., Lee S.H., Suh S.W., Keny S.M., Telang S.S. Bifocal tibial corrective osteotomy with lengthening in achondroplasia: an analysis of results and complications. J Pediatr Orthop. 2006;26(6): 788-793. doi: 10.1097/01.bpo.0000242429.83866.97.

[64] Eralp, L., Kocaoglu, M., Cakmak, M., Özden, V. E. A correction of windswept deformity by fixator assisted nailing: a report of two cases //The Journal of Bone and Joint Surgery. British volume. – 2004. – Т. 86. – №. 7. – С. 1065-1068. https://doi:10.1302/0301-620x.86b7.14923

[65] Matsubara H., Tsuchiya H., Kabata T., Sakurakichi K., Watanabe K., Tomita K. Deformity correction for vitamin D-resistant hypophosphatemic rickets of adults. Arch Orthop Trauma Surg. 2008;128(10):1137-1143. doi: 10.1007/s00402-007-0548-8.

[66] Song H. R. et al. Deformity correction by external fixation and/or intramedullary nailing in hypophosphatemic rickets //Acta Orthopaedica. – 2006. – Т. 77. – №. 2. – С. 307-314. https://doi:10.1080/17453670610046073

[67] Naqui S.Z., Thiryayi W., Foster A., Tselentakis G., Evans M., Day J.B. Correction of simple and complex pediatric deformities using the Taylor-Spatial Frame. J Pediatr Orthop. 2008;28(6):640-647. doi: 10.1097/BPO.0b013e3181831e99.

[68] Eralp, L., Kocaoglu, M., Toker, B., Balcı, H. I., Awad, A. Comparison of fixator-assisted nailing versus circular external fixator for bone realignment of lower extremity angular deformities in rickets disease //Archives of orthopaedic and trauma surgery. – 2011. – Т. 131. – №. 5. – С. 581-589. https://doi:10.1007/s00402-010-1162-8

[69] Koren L., Keren Y., Eidelman M. Multiplanar Deformities Correction Using Taylor Spatial Frame in Skeletally Immature Patients. Open Orthop J. 2016;10:71-79. doi: 10.2174/1874325001610010603.

[70] Kocaoglu, M., Bilen, F. E., Sen, C., Eralp, L., Balci, H. I. Combined technique for the correction of lower-limb deformities resulting from metabolic bone disease //The Journal of Bone and Joint Surgery. British volume. – 2011. – Т. 93. – №. 1. – С. 52-56. https://doi:10.1302/0301-620x.93b1.24788

[71] Riganti S., Nasto L.A., Mannino S., Marrè Brunenghi G., Boero S. Correction of complex lower limb angular deformities with or without length discrepancy in children using the TL-HEX hexapod system: comparison of clinical and radiographical results. J Pediatr Orthop B. 2019;28(3):214-220. doi: 10.1097/BPB.0000000000000573.

[72] Hughes, A., Heidari, N., Mitchell, S., Livingstone, J., Jackson, M., Atkins, R., Monsell, F. Computer hexapod-assisted orthopaedic surgery provides a predictable and safe method of femoral deformity correction //The Bone & Joint Journal. – 2017. – Т. 99. – №. 2. – С. 283-288. https://doi:10.1302/0301-620x.99b2.bjj-2016-0271.r1

[73] Ray V., Popkov D., Lascombes P., Barbier D., Journeau P. Simultaneous multisegmental and multifocal corrections of complex lower limb deformities with a hexapod external fixator. Orthop Traumatol Surg Res. 2023;109(3):103042. doi: 10.1016/j.otsr.2021.103042.

[74] Vaidya, S. V., Song, H. R., Lee, S. H., Suh, S. W., Keny, S. M., Telang, S. S. Bifocal tibial corrective osteotomy with lengthening in achondroplasia: an analysis of results and complications //Journal of Pediatric Orthopaedics. – 2006. – Т. 26. – №. 6. – С. 788-793. https://doi:10.1097/01.bpo.0000242429.83866.97

[75] Chaudhary M.M., Lakhani P.H. Double-level fixator-assisted nailing (DL-FAN). Bone Joint J. 2019;101(2):178-188. doi: 10.1302/0301-620x.101b2.bjj-2018-0622.r1.

[76] Watanabe, K., Tsuchiya, H., Sakurakichi, K., Matsubara, H., Tomita, K. Double-level correction with the Taylor Spatial Frame for shepherd's crook deformity in fibrous dysplasia //Journal of Orthopaedic Science. – 2007. – Т. 12. – №. 4. – С. 390. https://doi:10.1007/s00776-007-1132-3

[77] Артемьев А.А., Шипулин А.А., Абросимов М.Н. Корригирующие остеотомии на уровне бедра и голени в лечении и профилактике гонартроза при варусной и вальгусной деформации. В кн.: II Международный конгресс ассоциации ревмоортопедов: тезисы документов. 2018. c. 7-8. Режим доступа: https://www.elibrary.ru/download/elibrary_36811524_56467721.pdf. Artem’ev A.A., Shipulin A.A., Abrosimov M.N. Corrective osteotomy at the level of the femur and lower leg in the treatment and prevention of gonarthrosis in varus and valgus deformity. In: II International Congress of the Association of Rheumo-Orthopedists. 2018. р. 7-8. Available from: https://www.elibrary.ru/download/elibrary_36811524_56467721.pdf. (In Russian).

[78] Matsubara, H., Tsuchiya, H., Kabata, T., Sakurakichi, K., Watanabe, K., Tomita, K. Deformity correction for vitamin D-resistant hypophosphatemic rickets of adults //Archives of orthopaedic and trauma surgery. – 2008. – Т. 128. – №. 10. – С. 1137-1143. https:// doi:10.1007/s00402-007-0548-8

[79] Manner H.M., Huebl M., Radler C., Ganger R., Petje G., Grill F. 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. 2007;1(1):55-61. doi: 10.1007/s11832-006-0005-1.

[80] Naqui, S. Z. H., Thiryayi, W., Foster, A., Tselentakis, G., Evans, M., Day, J. B. Correction of simple and complex pediatric deformities using the Taylor-Spatial Frame //Journal of Pediatric Orthopaedics. – 2008. – Т. 28. – №. 6. – С. 640-647. https://doi:10.1097/bpo.0b013e3181831e99

[81] Donnan L.T., Saleh M., Rigby A.S. Acute correction of lower limb deformity and simultaneous lengthening with a monolateral fixator. J Bone Joint Surg Br. 2003;85(2):254-260. doi: 10.1302/0301-620x.85b2.12645.

[82] Koren L., Keren Y., Eidelman M. Multiplanar deformities correction using Taylor Spatial Frame in skeletally immature patients //The Open Orthopaedics Journal. – 2016. – Т. 10. – С. 71. https:// doi:10.2174/1874325001610010603

[83] Аранович А.М., Стогов М.В., Гасанова А.Г., Коркин А.Я. Состояние минерального обмена у детей с фосфат-диабетом при коррекции деформаций нижних конечностей методом Илизарова. Гений ортопедии. 2011(1):71-74. Aranovich A.M., Stogov M.V., Gasanova A.G., Korkin A.Ya. Mineral metabolism condition in children with phosphate diabetes for correction of lower limb deformities by the Ilizarov method. Genij Ortopedii. 2011(1):71-74. (In Russian).

[84] Riganti, S., Nasto, L. A., Mannino, S., Marrè Brunenghi, G., Boero, S. Correction of complex lower limb angular deformities with or without length discrepancy in children using the TL-HEX hexapod system: comparison of clinical and radiographical results //Journal of Pediatric Orthopaedics B. – 2018. – Т. 28. – №. 3. – С. 214-220. https:// doi:10.1097/bpb.0000000000000573

[85] Mayer S.W., Hubbard E.W., Sun D., Lark R.K., Fitch R.D. Gradual Deformity Correction in Blount Disease. J Pediatr Orthop. 2019;39(5):257-262. doi: 10.1097/BPO.0000000000000920.

[86] Ray, V., Popkov, D., Lascombes, P., Barbier, D., & Journeau, P. Simultaneous multisegmental and multifocal corrections of complex lower limb deformities with a hexapod external fixator //Orthopaedics & Traumatology: Surgery & Research. – 2021. – С. 103042. https://doi:10.1016/j.otsr.2021.103042

[87] Lu Y., Li J., Qiao F., Xu Z., Zhang B., Jia B. et al. Correction of severe lower extremity deformity with digital hexapod external fixator based on CT data. Eur J Med Res. 2022;27(1):252. doi: 10.1186/s40001-022-00887-6.

[88] Chaudhary M. M., Lakhani P. H. Double-level fixator-assisted nailing (DL-FAN) //The Bone & Joint Journal. – 2019. – Т. 101. – №. 2. – С. 178-188. https://doi:10.1302/0301-620x.101b2.bjj-2018-0622.r1

[89] Dammerer D., Kirschbichler K., Donnan L., Kaufmann G., Krismer M., Biedermann R. Clinical value of the Taylor Spatial Frame: a comparison with the Ilizarov and Orthofix fixators. J Child Orthop. 2011;5(5):343-349. doi: 10.1007/s11832-011-0361-3.

[90] Артемьев А. А., Шипулин А. А., Абросимов М. Н. Корригирующие остеотомии на уровне бедра и голени в лечении и профилактике гонартроза при варусной и вальгусной деформации //II Международный конгресс ассоциации ревмоортопедов. – 2018. – С. 7-8. Режим доступа: https://www.elibrary.ru/download/elibrary_36811524_56467721.pdf

[91] Hasler C.C., Krieg A.H. Current concepts of leg lengthening. J Child Orthop. 2012;6(2):89-104. doi: 10.1007/s11832-012-0391-5.

[92] Artem'ev A. A., Shipulin A. A., Abrosimov M. N. [Corrective osteotomy at the level of the femur and lower leg in the treatment and prevention of gonarthrosis in varus and valgus deformity] II Mezhdunarodnyj kongress associacii revmoortopedov [II International Congress of the Association of Rheumo-Orthopedists] – 2018. – С. 7-8. Режим доступа: https://www.elibrary.ru/download/elibrary_36811524_56467721.pdf (In Russ.)

[93] Keshet D., Eidelman M. Clinical utility of the Taylor spatial frame for limb deformities. Orthop Res Rev. 2017;9:51-61. doi: 10.2147/ORR.S113420.

[94] Manner H.M., Huebl M, Radler C, Ganger R, Petje G, Grill F. 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 2007; 1(1): 55–61. https://doi:10.1007/s11832-006-0005-1

[95] Donnan L. T., Saleh M., Rigby A. S. Acute correction of lower limb deformity and simultaneous lengthening with a monolateral fixator //The Journal of Bone and Joint Surgery. British volume. – 2003. – Т. 85. – №. 2. – С. 254-260. https://doi:10.1302/0301-620x.85b2.12645

[96] Аранович, А. М., Стогов, М. В., Гасанова, А. Г., Коркин, А. Я. Состояние минерального обмена у детей с фосфат-диабетом при коррекции деформаций нижних конечностей методом Илизарова //Гений ортопедии. – 2011. – №. 1. – С. 71-74. УДК 612.015.31-053.2:616.632.1:616.718-007.24-089.227.84

[97] Aranovich A.M., Stogov M.V., Gasanova A.G., Korkin A.Ya. [Mineral metabolism condition in children with phosphate diabetes for correction of lower limb deformities by the Ilizarov method] Genij ortopedii [Orthopaedic genius] – 2011. – №. 1. – С. 71-74. (In Russ.)

[98] Mayer, S. W., Hubbard, E. W., Sun, D., Lark, R. K., Fitch, R. D. Gradual deformity correction in Blount disease //Journal of Pediatric Orthopaedics. – 2016. – Т. 39. – №. 5. – С. 257-262. https:// doi:10.1097/bpo.0000000000000920

[99] Lu, Y., Li, J., Qiao, F., Xu, Z., Zhang, B., Jia, B., Cao, X. Correction of severe lower extremity deformity with digital hexapod external fixator based on CT data //European Journal of Medical Research. – 2022. – Т. 27. – №. 1. – С. 252 https:// https://doi.org/10.21203/rs.3.rs-1708829/v2

[100] Dammerer, D., Kirschbichler, K., Donnan, L., Kaufmann, G., Krismer, M., Biedermann, R. Clinical value of the Taylor Spatial Frame: a comparison with the Ilizarov and Orthofix fixators //Journal of children's orthopaedics. – 2011. – Т. 5. – №. 5. – С. 343-349. https://doi:10.1007/s11832-011-0361-3

[101] Hasler C. C., Krieg A. H. Current concepts of leg lengthening //Journal of children's orthopaedics. – 2012. – Т. 6. – №. 2. – С. 89-104. https:// doi:10.1007/s11832-012-0391-5

[102] Keshet D., Eidelman M. Clinical utility of the Taylor spatial frame for limb deformities //Orthopedic Research and Reviews. – 2017. – С. 51-61. https://doi:10.2147/orr.s113420

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