Abstract
Introduction
To report our early experience and suitability over unicortical fixation system to reduce and hold the bone fragments in position during a CHAOS procedure of the femur or tibia during lower limb reconstruction surgery.
Materials and Methods
We report a case series of the first consecutive 10 patients (11 bones) for which this CHAOS technique was used between May 2017 and October 2019 by the same surgeon.
The novel aspect of the procedure was the use of a unicortical device, Galaxy UNYCO (Orthofix, Verona, Italy), which eliminate the need for any change of fixation during the procedure. It also means the intramedullary canal was left free for the intramedullary nailing.
Results
We treated 4 femurs and 7 tibias with this technique without any loss or failure of the construct. We treated uniplanar and multiplanar deformities with the angulations between 8 degrees of valgus to 15 degrees of varus and from 0 to 8 mm translation in the AP view, from 20 degrees procurvatum to 15 degrees recurvatum and 0 to 2 mm translation on the lateral view and from 20 degrees internal rotation to 5 degrees external rotation and 0 to 10 mm translation on axial view.
Conclusions
The construct was able to deal with the total tension in the system both in the correction phase and the additional stress applied during insertion of a nail such as reaming and impacting the nail to the canal.
The potential advantage also included the possibility of intramedullary nailing without interference with the external fixation device.
