Dr. Axel Becker is a specialist in leg lengthening, a specialist in plastic, aesthetic and reconstructive surgery, a specialist in orthopedics and trauma surgery and carries out cosmetic leg lengthening in his special clinic in Freiburg. For this purpose – only here – a minimally invasive leg lengthening method BETZBONE®, developed by him and unique in the world, is used.
We have explained the point “stability of internal leg extension systems” and the advantages that the BETZBONE® extension nail has in this point many times. But what about the stability of external extension systems (fixators/ring fixators)?
Read what leg lengthening specialists Dr. med. A. Becker and Professor Dr. med. A. Augustin says about this and what his own experiences have been with external fixators.
“Maintaining length, maintaining shape, maintaining axis, that’s what we focus on when we talk about the stability of leg extension systems.”
External fixators: What can the external fixator do? We quote Prof. Dr. A. Augustin:
“The external fixator was originally an instrument to stabilize difficult bone fractures: wide-open fractures, major soft tissue damage, i.e. bone damage where you are not immediately able to insert stabilization systems into the bone. All conditions that Dr. Becker pointed out in plastic surgery and orthopedics In such cases we had to resort to the fixator in the past. In the past, we used a fixator for almost every bone fracture that could not be treated conservatively Because the bone doesn’t need that at all. The fixator was originally only intended for difficult soft tissue situations, to calm the soft tissues, to heal the soft tissues If the bone is very badly affected and the bone is perhaps even completely exposed, healing will not work. The external fixator was a good instrument for these soft tissue situations, even to this day.
I can report from my experience that I have often used these fixators for the purpose of soft tissue healing. But I also have to say that I was always reluctant to allow a broken bone to heal in a ring fixator. Because you have to know that this involves endless effort: caring for the pins, i.e. the pins that go through the skin. These pins had to be moved again and again or completely repositioned, which always required further surgical intervention. And these pins were infected, so never dramatic; there was rarely a serious infection. Nevertheless, if I could avoid it as a doctor, I also avoided the external fixators.
So much for healing bone fractures with a ring fixator. Just thinking about doing leg lengthening with external fixators like that….
You always have to go through the skin, through soft tissue and also through muscles. This always causes irritation, infections and has many other disadvantages in terms of axis displacement, tissue tension, etc. All things that are difficult to predict and even more difficult to correct. So let me make myself clear. The fixator is already a stable system – for immobilization in the event of a bone fracture. But not really suitable for leg lengthening. And our aim here is to offer patients the best systems for leg lengthening.”
CONCLUSION: The ring fixator offers high stability. Does it offer adequate conditions over the entire period of leg lengthening? That is rather questionable.
Stability – monolateral system
With the monolateral system we encounter the difficulty that the increasing muscle tension creates a bending force. An attempt is made to counteract this deformation with an additional internal nail.
So you always need two systems for leg lengthening, because one doesn’t work on its own.
“Monolateral fixators (without additional internal systems, LON) should be viewed extremely critically for large distraction distances/leg lengthening in the lower leg and thigh areas.”
Dr. med. A. Becker, leg lengthening specialist, Freiburg in Breisgau
