When Is A Circular Frame Required?
Below, you will find a brief list of occasions when a circular frame is required for treatment. Your consultant and his or her team will discuss the details of your planned surgery and what alternatives there are. Sometimes, there are no good alternatives, or the alternatives have risks of their own which make them problematic. The advantage of the frame is that it usually allows you to weight bear.
Fracture Non-Union. This means that a previous fracture, perhaps treated previously with metalwork, has not healed. We will take samples at your surgery to ensure that it is not complicated by infection. The internal metalwork may also need to be removed, and the external fixator supports the bone after surgery, until it has healed properly
Fracture Mal-Union. A frame can be used to deal with limb deformity, which may be due to a previous healed fracture. This change in the alignment of a limb can cause problems with the joints on either side or the spine. If one leg has become shorter, a limp will result. The frame allows the controlled growth of bone to correct a deformity.
Limb Lengthening or Deformity Correction. If one limb is longer than the other, a limp can result and it is can also cause problems with joints in the limb and the other limb. This may be due to problems in growth. It is also possible for the limb to be deformed due to problems with growth. We can use controlled growth of a bone using the circular frame to correct the shortness of one limb, or change the alignment.
Osteomyelitis. This is infection in the bone. It can happen in any bone of the body but typically happens at the site of previous surgery or injury. Sometimes, it can occur when an infection travels around the blood and lodges in a bone.
Longstanding osteomyelitis is treated with a combination of antibiotics and surgery. The surgery is required to remove any diseased bone and metalwork that may be harbouring infection. Usually, unless metalwork is removed, the infection continues. We frequently use antibiotic beads as well as antibiotic injections or tablets. We take samples to ensure that the bacteria causing the infection is treated with the appropriate antibiotic. If there is infection in soft tissues as well as the bone, the plastic surgery team may need to be involved to help with the surgery.
Complex Fractures. Some fractures cannot be treated by conventional means. This may because there are too many pieces or the fracture enters a joint. Sometimes, conventional treatment with metal plates or rods are not possible because of a high risk of infection or the skin dying over the fracture. The soft tissues such as skin, fat and muscle may be severely injured at the same time as the fracture occurred. Although applying a plate may seem easier, we have to weigh up the risk of complications and benefits for each individual. We know that with soft tissue injuries, there are high risks of complications, and that frames are kinder to the soft tissues, and can aid healing. Circular frames allow weight bearing immediately, so that some problems common after other treatments can be avoided. These include chest infections, urine infections, bed ulcers, blood clots in the leg and lungs, and muscle weakness.