Correction of multiapical deformities of the lower libs: Review

Abstract

Relevance Multiapical deformities (MD) of the lower limbs - there're hard and widespread orthopedic pathology. Unfortunaly, there're not found any works with a comprehensive assessment of modern views on the problem of treating patients with multiapical deformities of long bones. Purpose. Using the world literature, to identify the modern position, problems and prospectives of the correction of multialical deformities of the lower limbs. Methods. PubMed, SAGE Publishing Journals, Embase, MEDLINE, eLIBRARY, КиберЛенинка, Google Scholar resources were used. At analyzis several criterial were used: diagnostic, planning and approaches of correction of the multiapical deformities. Results. Terms "multiapical deformity" and "multilevel deformity" used as a synonymes. At the same time, term "multilevel deformity" is used to refer to uniapical deformities of different limb segments. The main diagnostic sign of multiapical deformity is the location of the apex outside the bone. In MD planning uses the axis of the middle/intermediate fragment(s). Most authors define it as the middiaphyseal line. Correction of multiapical deformities can be realyzed acute or gradual. Acute correction is more comfortable for the patient. If there are contraindications, it's performed gradually using "Ilizarov hinges" or orthopedic hexapods. Conclusion. Term "multiapical deformity" is more correct for using to definity the researced pathology. The main diagnostic sign of MD is not absolute and requires clarification. When planning a correction, there are difficulties in the case of using mechanical axes, as well as when it is necessary to determine the axis of a non-linear middle fragment. The "spring technique" of using an orthopedic hexapod has significant advantages, but it's necessary to clarification the optimal characteristics of the elastic rods (springs), the points of their fixation to the frame and method of using the hexapod computer program. The solution of these problems will improve the efficiency of treatment of patients with multiapical deformities.