Techniques

FAN (fixator assisted nailing)

  •  Temporary external fixator pins are placed on the leg or deformed bone.

  • The bone is then broken (osteotomized) at the location of correction through a small incision.
  • The external fixator is then used to correct the deformity.
  • The accuracy of the correction is then assessed using x-rays and measurements in the operating room.

  • Once the correction is achieved, the nail is then inserted and locked.

  • The external fixator is then removed.
  • The patient never sees this device, it is simply used to aid in correcting the limb deformity during surgery and does not have it upon waking in the recovery room.
  • The skin is closed and the patient is brought to the recovery room.
  • See case example FAN

FAP (fixator assisted plating)

  • This is the same technique as FAN, but instead of using a nail as the final fixation, we use a plate.
  • See case example FAP

Advantages of fixator assisted techniques (FAN and FAP):

  • Improved accuracy of deformity correction (compared to non-fixator assisted techniques)
  • X-ray verification of bone alignment during operation
  • Ensures proper rotation of the bone during fixation
  • Very small incisions
  • The patient never has to see or endure the external fixator as it is removed in the operating room prior to waking.

Post-Operative Care

Immediately after surgery, patients are allowed toe touch weight bearing on the operated leg.

Patients can expect to be hospitalized for 24-48hrs after the surgery.

The dressings are changed in the hospital on post-operative day 1 or 2 and then kept until the first clinic visit.

Seven days after surgery there is the first follow-up. The wound will be checked and x-rays will be taken.

Generally, the clinic visits and x-ray follow up are then at 6 weeks, 3 months and 6 months post-operatively.

Physiotherapy after surgery

Mobilisations of the joint proximal and distal to the osteotomy must begin immediately.

Total weight bearing can begin generally after the 6 weeks follow-up

Potential complications

  • Delayed union, non-union or malunion of the bone
  • Superficial (skin and soft tissues) or deep infection (bone infection)
  • Neurovascular injury (very rare)
  • Compartment syndrome (very rare)

 

For a complete list of the risks and complications, please see Patient info.

Patients who will undergo this procedure should read the following sections in the Patient information tab.

1- Immediate post-operative care