Q1: What is a Hexapod Fixator, and what makes it fundamentally different?
A1: A Hexapod Fixator is a computer-assisted circular external fixator that uses six adjustable struts to connect two rings. Unlike traditional frames with fixed rods, these six struts create a “virtual hinge,” allowing for precise, simultaneous 3D correction of complex deformities after surgery using a simple software-generated prescription.

Q2: How does the “virtual hinge” work, and why is it a game-changer?
A2: The “virtual hinge” is a mathematical concept, not a physical part. By independently lengthening or shortening each of the six struts by a calculated amount, the software can make the bone move in any desired path—correcting length, angulation, rotation, and translation all at once. This eliminates the need for complex, custom-made physical hinges and simplifies incredibly difficult corrections.

Q3: What is the single biggest advantage of a Hexapod over a traditional Ilizarov frame?
A3: Unmatched Simplicity and Precision in Correcting Complex Deformities.

Ilizarov Frame: Requires the surgeon to physically build the correction into the frame using specific hinges and threaded rods. This demands exceptional pre-operative planning and is prone to error. Each deformity (e.g., angulation AND translation) often requires a separate, sequential correction.

Hexapod Frame: The frame is applied in a “neutral” or “mounting” position. The surgeon measures the residual deformity on X-rays/CT scans, inputs these parameters into specialized software, and the computer outputs a daily “recipe” of strut lengths for the patient to follow. This corrects all aspects of the deformity simultaneously and accurately.

Q4: In which clinical scenarios is a Hexapod Fixator the undisputed best choice?
A4: It is the gold standard for:

Complex, Multi-Axial Deformities: Deformities with angulation, translation, and rotation combined.

Limb Lengthening with Concurrent Deformity Correction.

Correcting Malunions (healed fractures in a bad position) where the deformity is in six axes.

Limb Reconstruction after trauma or tumor resection with significant bone loss or deformity.

Q5: What are the key disadvantages or challenges of using a Hexapod system?
A5:

Cost: The systems and the required software are significantly more expensive than traditional Ilizarov components.

Learning Curve: Surgeons require training in the software and the principles of deformity analysis.

Reliance on Technology: The entire process depends on accurate radiographic measurements and correct software use.

Frame Bulk: It can be bulkier than a monolateral fixator.

Q6: How does the precision of a Hexapod compare to other methods?
A6: It provides sub-millimeter and sub-degree precision. When the pre-operative measurements and frame mounting are accurate, the final anatomical result is exceptionally close to perfect alignment, often superior to what can be reliably achieved with manual techniques in complex cases.

Q7: Can a Hexapod be used for simple lengthening, or is it overkill?
A7: It can be used for simple lengthening, and some surgeons prefer it for its “forgiving” nature regarding initial frame application. However, for a straightforward, diaphyseal lengthening with no deformity, a monolateral rail fixator is often preferred as it is less bulky, cheaper, and simpler for the patient to manage. The Hexapod’s power is best utilized when complexity is involved.