Break a Leg, Bradley: A Look into the Use of Intentional Deformity & Hexapod Frames Following Major Tibia Injuries
by Abby Adera
Bradley Lezak, MD, MPH, 2022 Other Interests: baseball, Admissions Ambassador, OSIG E-Board, Anatomy TA, Quality Control Director at San Juan Bosco Clinic Mentor: Dr. Stephen Quinnan, MD- Chief of Orthopedic Trauma Surgery Future Goals: Orthopedic Surgery
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he year is 2006, and 12-year old Bradley Lezak has just taken a nasty tumble on the football field. Seconds later, he boasts a fully snapped tibia and fibula and is on the way to meeting his first orthopeadic surgeon. Flash forward to the year 2020 and Bradley finds himself yet again in an Orthopaedic Trauma department, only now he wears the title of a MS2 M.D./M.P.H candidate working diligently under Chief of Orthopaedic Trauma Surgery Dr. Stephen Quinnan, M.D. The work? A fascinating new approach to treating complex, acute open tibia fractures. Unlike closed fractures, orthopaedic surgeons often struggle in their methods of finding ways to close the skin following the stabilization of the tibia bone. Dr. Quinnan’s method is revolutionary in that it involves intentionally deforming the bone, in extreme cases with an angle that nears that of ninety degrees. By this process, soft tissue closure is possible.
hexapod frame is able to straighten the leg slowly over the course of 1-2 months to an ideal linear position. The multiplanar structure of the Hexapod is exponentially more versatile than the uniplanar external fixator alternatives, which cannot be manipulated postoperatively. Bradley Lezak’s role is a retrospective look into the x-rays, surgical notes, and development of patient cases in which this intentional deformity and hexapod frame technique was used to treat major open tibia injuries. He is working on a first-author publication detailing the theory, procedure, and patient outcomes of Dr. Quinnan’s unique technique. Nowhere else in the country is the intentional deformity and hexapod frame combo utilized; this paper will expose this novel treatment of complex open tibia fractures to orthopaedic trauma centers nationwide potentially leading to widespread integration.
That’s not all of the genius. Dr. Quinnan then applies a multiplanar external fixator frame called a Hexapod (Taylor Spatial) around the whole leg of the patient. The root “hexa” refers to the ability of the external fixator to mend six-axis deformities simultaneously with its two ring, six leg structure. These legs, referred to as struts, can be manipulated to different lengths, and the rings can be stretched or minimized in their diameters. All of these possible changes are guided by a computer software that is integrated into the frame. This software specialized for each patient case marks a collaboration between Dr. Quinnan’s team and an independent biotechnology company. Like magic the
The Medical I.B.I.S. | Spring 2020
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