ABSTRACT
An innovative uniplanar–bilateral external fixator was designed, developed, and implemented
for barrel-vault osteotomy of the proximal tibia. Eighteen cases of medial compartmental
osteoarthritis of the knee with genu varum and one case of tibia vara were treated
with dome osteotomy fixed with this new fixator to meet patient expectations regarding
pain relief, early recovery with ability to squat, dependency periods, avoiding serious
complications, convenience, and economic conditions. All cases achieved the desired
degree of bony correction except for one case with 5° undercorrection due to preoperative
posterolateral corner laxity. Plaster immobilization was not required during the treatment
period, and all osteotomies united within 6-10 weeks with no major complications.
Superficial pin tract infection occurred in three cases. All patients returned to
their activities of daily living by postoperative week 2. The Knee Society Score was
75-100 with average function/knee scores of 88.89/96.32 by the end of 2 months. Patients
maintained these scores up to 2-year follow-up. This new fixator is compact and economical,
with excellent patient compliance. It provides a stable fixation for the osteotomy
and permits early joint mobilization, full weight bearing, and early return to activities
of daily living. The fixator has the ability to alter correction in the early postoperative
period to achieve a precise correction of the deformity. It qualifies as a safe device
for this procedure, produces reliable and reproducible results, as well as satisfies
patient expectations.
