Benefits of the OrthoPro
RX-Fix External Fixator:
| Patented pin clamp
allows transverse and frontal plane
placement of the pins, also allows
compression or distraction of the pins. |
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| Percutaneous placement helps minimize soft
tissue dissection and periosteal stripping
preventing postoperative swelling and
increasing healing rate of bone. |
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| Allows for early
weight-bearing, range of motion, and
healing. |
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| Pins removed in the office under local
anesthesia |
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| Pricing is best in the
industry |
Preoperative
Post-Operative |
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RX-Fix
External Fixator Surgical Procedure |
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 A
large longitudinal linear
incision is placed from the
first cuneiform to the base of
the proximal phalanax. The
incision remains medial to the
extensor hallucis longus.
Proximally, the incision is
directly dorsal from the first
metatarsocuneiform to the joint
laterally. This incision also
helps avoid the dorsomedial
cutaneous ner |
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 A
capsulotomy exposes the
first metatarsophalangeal
joint. The hypertrophic
medial eminence is resected
from the metatarsal head.
Laterally, soft tissue
release is accomplished by
resection of the conjoined
adductor tendon in the first
interspace. |
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 Proximally,
the dorsomedial cutaneous is
never identified or
retracted. The first
metatarsocuneiform joint is
exposed by reflecting the
capsule and periosteom.
An osteotome or sagital saw is
used to remove the cartilage
from the joint. Care is
taken to leave the
subchondral plate intact to
retain as much length is
possible. A laminar spreader
is used to allow access to
the plantar cartilage at the
deeper part of the joint.
The subchondral bone is
drilled and scalloped to
promote bleeding in order to
increase successful fusion.
Manual reduction of the
first metatarsal in the
transverse and sagittal
planes is performed in most
cases without further bone
resection. In cases of
medially angulated
cuneiforms, a sagittal saw
is used to plane the lateral
aspect of the joint to gain
the desired correction. |
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 A
K-wire is used for temporary
fixation and alignment is
checked with fluoroscopy.
Rigid internal fixation is
achieved with a 3.5/4.0
cannulated partially
threaded OrthoPro Screw,
placed from the dorsal
cortex of the first
metatarsal base crossing the
joint to the plantar surface
of the medial cuneiform.
This screw is well
countersunk to allow the
screw head to compress the
dorsal cortex perpendicular
to the joint, and usually
measures 40 to 50 mm in
length. |
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 The
external fixation is placed
on the wound has been
closed. Using fluoroscopy,
the first pin is placed
percuntaneously on the
medial side of the foot
parallel to both the joint
and the plantar aspect of
the foot. This pin is placed
in the distal half of the
medial cuneiform. The second pin is
placed in the first
metatarsal shaft distal to
the cannulated screw head.
Care is taken to keep the
second pin placement
parallel with the first pin.
Next, the external fixator is
placed over the pins using
the inner holes of the pin
clamps. Sequentially, the
outer pins are placed
directly through the
external fixator. The
T-handle wrench is used to
tighten the fixator to the
pins and to apply
compression until a very
slight bend is seen in the
pins. Final correction and
fixation is then
radiographicly documented. |
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Patients are
placed in a post
operative shoe
over sterile
dressings and
allowed to be
full
weight-bearing.
The first week
they are
instructed to do
as little
ambulation as
possible, and to
keep the foot
elevated.. The
dressings are
changed one week
post operatively
at which time
patients are
instructed as to
pin care. |
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TWO WEEKS
At two weeks
patients are
allowed to get
the foot wet and
to continue with
progressive
ambulation as
tolerated.
Patients are
seen every other
week or sooner
if needed and
the fixator is
tightened and
compressed (Xrays
are taken at 3
and 5 weeks
post-op). |
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FIVE WEEKS
Once fusion is
seen
radiographicly (usually at 5
weeks post
operatively) the
external
fixation is
removed in the
office with
local
anesthesia. The
patient is then
allowed full
weight-bearing
in an ankle
walking boot for
2 to 3 weeks. By
week 8, patient
generally
returns to
regular footwear
and activities
as tolerated. |
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Click Here
for a printable Instructions For Use (IFU) for our RX-Fix
External Fixator.
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