External Fixation Device Locks Surgical Correction Into Place

An emerging device offers external fixation for non-unions, limb lengthening procedures and fractures, building upon the reconstruction techniques developed by the late Russian Professor Gavril Ilizarov.

The TrueLok System can help surgeons lengthen limbs by metaphyseal or epiphyseal distractions, fixate open and closed fractures, treat non-union of long bones, and correct bony or soft tissue defects or deformities, according to the manufacturer Orthofix. TrueLok is indicated for fixation of Charcot foot, cavus foot, pes planus, ankle arthrodesis, lower extremity fractures, and trauma and post-trauma deformity, notes Orthofix. The company adds that surgeons can use the ex fix system to help treat congenital conditions including Blount’s disease, clubfoot, rickets, genu varum, genu valgum and arthrogryposis.

Victor Nwosu, DPM, has used TrueLok for approximately three years and has had a “very good experience” with the product. Dr. Nwosu says the TrueLok is most effective for reconstructive surgery of the foot and ankle. He has also used the TrueLok system in those patients with ankle trauma for whom an open technique may not be a good option.

TrueLok has several advantages over other ex fix products, including its ease of use, light weight, solid frame and reproducible results, according to Dr. Nwosu, who is in private practice at the CORE Institute in Michigan. In addition, “the training (for the product) is world class. One receives training from Ilizarov trained surgeons,” says Dr. Nwosu.

Orthofix says the TrueLok system has circular rings and semi-circular external supports centering on the patient’s limb, and crossed, tensioned wires and half pins secure the supports to the bone. The ex fix system promotes stable bone fixation through externally connected rings, which utilize threaded rods, linear distractors, or hinges and angular distractors, permitting the surgeon to adjust the relative position of rings to each other, according to Orthofix. The company notes surgeons can manipulate the ring positions either acutely or gradually in minute increments to correct the deformity, lengthen limbs, or transport bone segments.

TrueLok has pre-assembled hinges and angular distractors, which the manufacturer says can help preserve alignment even when one temporarily disconnects them during osteotomy, frame manipulation or component exchange, Orthofix notes. The company adds that TrueLok’s universal components, such as the wire and half pin fixation bolts, have serrations and grooves for superior bone segment stabilization.

Furthermore, the modular nature of TrueLok’s system permits surgeons to customize frame constructs to treat numerous orthopedic conditions with fewer components, notes the company. Orthofix says having full control of bone segments with TrueLok allows the precise movement of segments without compromising stability.

Orthofix cautions that the application of a circular external fixator and postoperative management requires appropriate experience and skill on the part of surgeons. It adds that building a specific frame to treat an individual case is fundamentally important to the successful outcome of the procedure.