Correcting Midfoot Charcot with a Hexapod Frame
Summary: Shane Sato, DPM, and Michael H. Theodoulou, DPM, FACFAS present a surgical pearl describing the use of hexapod frame external fixation (TL-Hex TrueLok Hexapod System) to correct complex midfoot Charcot deformity. The technique allows for multiplanar correction, acute or gradual deformity management, with implications for limb salvage and improved structural alignment in diabetic Charcot foot.
Key Highlights:
- The hexapod frame uses six adjustable struts that facilitate correction across multiple planes, including angular, translational, and rotational deformities.
- Early (acute) correction is possible for reducible deformities—even in what’s traditionally considered the acute stage—when linked with external fixation and software-guided alignment.
- Preoperative planning involves software input: taking AP and lateral radiographs with calibration, choosing reference segments, and entering deformity parameters into frame planning software.
- In the reported case, acute deformity correction restored alignment (e.g., restored Meary angle), followed by internal fixation if needed; the hexapod method supports access to wounds and earlier weight-bearing compared to internal methods alone.
Read the full Surgical Pearls article on Podiatry Today
Keywords:
midfoot Charcot,
hexapod frame,
external fixation,
deformity correction,
TL-Hex TrueLok,
Shane Sato,
Michael H. Theodoulou