37 year old lady doctor suffered from severe bowing deformities due to hereditary bowing deformities . She was misdiagnosed as having resistant renal rickets and hence could not get adequate treatment for this long.
Her full length x-rays show the severe varus bowing in the AP x-ray. The mechanical axis is passing at least 13 cm medial to the centre of the knee.
The lateral xray shows that there is a procurvatum deformity in the femur and a recurvatum deformity in the tibia.
The femur with its varus deformity in the AP and procurvatum deformity in the Lat view means that there was a deformity in the Oblique plane. This plane was found with trignometric formulae and with the graphic method. This was confirmed by taking x-rays by accurately positioning the patient in that plane. One x-ray showed a maximum deformity and the other one taken at 90 degrees to that plane showed no deformity at all.
First movie clip shows the graphic method of planning which takes measurements of AP and LAT x-rays and then gives the true plane of deformity and true magnitude of deformity and then also the placement of correction hinges and the motor rods in an ilizarov frame. This shows the process of finding the Oblique plane of the tibial deformity which had varus in AP and Recurvatum in the lateral x-rays. This shows the graphic method of planning which showed the plane of the deformity and also the placement of hinges.
This is also shown in the next second movie clip in the 3-D mode where the same deformity is seen in AP and then LAT views and the same is shown in the true plane which shows no deformity at all and then finally at right angles to it shows the deformity in its true maximum extent.
The third movie clip shows our method of simulation of the correction of the true tibial deformity. Simulation of surgery is necessary to ensure that the level of osteotomy is correct, the shape of osteotomy will achieve adequate bony contact to ensure early healing.
The fourth movie clip shows our method of simulation of surgery of the correction of the true femoral deformity. This is done very accurately by creating the outlines of the true deformity, drawing the axes, performing the osteotomy and simulating the correction.
The ilizarov fixator allows full movement and walking.
Shows full correction of the deformities and a very nice correction. The full length x-ray also shows the full correciton with the mechanical axes passing within the centre of both knees. Finally, it shows the knee bending fully and allowing full function.
