Six-Axis Circular Frame Correction in Sharjah
Medically reviewed by Dar Al Kamal Team
What is six-axis circular frame correction?
Six-axis circular frame correction is a method of straightening a deformed bone gradually using a hexapod frame: two rings fixed to the bone above and below the deformity, joined by six adjustable struts set at angles. Changing the lengths of the struts moves one ring relative to the other in any direction, so the frame can correct bending, twisting, sideways shift and shortening at the same time.
The name refers to the six directions a bone segment can move in: up and down, side to side, forwards and backwards, and three kinds of rotation. Real deformities usually combine several of these, and the hexapod corrects them all in one smooth movement.
A detail patients rarely expect: the correction is calculated by computer. After the frame is fitted, X-rays are measured and the figures entered into planning software, which produces a prescription schedule telling you exactly how far to turn each strut on each day. Because the bone moves in small daily steps, nerves, blood vessels, muscles and skin have time to adapt.
Dar Al Kamal Hospital, Sharjah performs six-axis frame correction in-house. The work is led by Dr. Mohamed Kamal, Consultant Orthopedic Surgeon, with more than two decades in orthopedics and trauma and a background as acting consultant in limb lengthening and deformity correction at Khoula Hospital in Oman.
Who needs it
Six-axis frame correction suits bone deformities that are large, involve more than one plane, or sit where skin and nerves benefit from gradual stretching. Typical reasons include:
- A fracture that healed crooked or twisted (malunion), causing a limp, uneven shoe wear or pain in the joints above and below.
- Bow legs or knock knees in adults or older teenagers, which change how load passes through the knee. Your surgeon discusses how alignment relates to future joint care, including knee replacement.
- Deformity around the ankle or foot, including a stiff, badly aligned foot after injury.
- Childhood conditions such as Blount's disease or a growth-plate injury, assessed with pediatric orthopedics.
- Deformity combined with shortening, where the frame straightens and lengthens together.
The main alternative is acute correction: dividing the bone, straightening it in one step and fixing it with a plate or nail. Acute correction suits smaller, simpler deformities. Children may be offered guided growth, and insoles or braces can ease symptoms. The choice depends on the size and shape of the deformity, the state of the skin, your bone quality and your daily life. Where bone loss or infection is the main problem, the limb reconstruction with external fixators page explains the approach.
What happens
- Measuring the deformity. Full-length standing X-rays and often a CT scan measure the angle, rotation and length difference.
- The operation. Under general anaesthesia, the rings are attached with wires and pins through small skin punctures, the bone is divided through a short incision at the planned level, and the six struts are connected.
- Building the schedule. X-rays taken with the frame in place are measured, the figures go into the planning software, and your printed prescription schedule is produced.
- Daily strut turns. After a short rest period, you follow the schedule. Each strut is numbered and colour-coded, and the team teaches you and a family member to read the chart and make each turn.
- Checking and fine-tuning. Clinic X-rays confirm the bone is moving as planned. If a small residual deformity remains, a new schedule fine-tunes the final position.
- Consolidation and removal. Once the alignment is right, the struts are locked, the new bone hardens, and the frame is removed in a shorter procedure under anaesthetic.
Our physical therapists work closely with our orthopedic surgeons throughout, keeping the knee and ankle moving while the bone shifts beneath them. Physiotherapy at Dar Al Kamal Hospital continues after the frame comes off.
Preparing for it
Bring earlier X-rays, scans and operation notes; old images show how the deformity has changed. Bring a full list of your medicines, and stop smoking before surgery to support bone healing.
Plan for the schedule. Choose one family member to learn the strut turns with you, set phone reminders for each turn, and keep the printed chart somewhere visible. Wide-leg trousers or trousers with side poppers fit over the rings, and a shower chair and clear walkways help at home. Patients from other emirates or abroad should plan to stay within easy reach of Sharjah during the correction stage. If treatment overlaps Ramadan, discuss it early so fasting, medicines and appointments can be arranged together.
Afterwards
Tick off each strut turn on your chart as you make it. Some turns produce a brief stretching feeling, which settles. Clean the pin sites daily as the nurses taught you; in the Sharjah heat, stay in cool spaces and keep the frame covered outdoors to limit sweat and dust. Walking with crutches or a walker is usually encouraged, following your surgeon's weight-bearing advice. Your surgeon gives you a personal timeline for returning to desk work, driving jobs or manual work.
Contact the hospital urgently if you miss or mis-turn a strut adjustment, a strut becomes loose or damaged, redness spreads around a pin, a pin site discharges, or you develop a fever or new numbness in the foot. **Go to the emergency department straight away if your foot becomes cold, pale or numb, your calf swells and aches, or you develop sudden breathlessness.**
Cost and insurance
Correcting a deformity caused by injury or a medical condition is usually treated as medically necessary, and most UAE insurance plans consider six-axis frame correction with pre-approval supported by X-rays, a CT scan and the surgeon's plan. The frame and its components may be covered under a separate limit, and some plans cap physiotherapy sessions. Dar Al Kamal Hospital, Sharjah can help you confirm cover and start approval early on 06 599 7777.
Related services
Frequently asked questions
What are the risks of six-axis circular frame correction?
Six-axis circular frame correction carries risks including pin site infection, bleeding, blood clots, nerve or blood vessel irritation, joint stiffness and a reaction to the anaesthetic. The new bone can heal slowly, and a small residual deformity may need a further schedule or procedure. Your surgeon explains how these risks apply to you before you decide.
Do I turn the struts myself?
Most people turn the struts of a six-axis frame themselves, or with a family member, following a printed daily schedule. The team teaches you before you go home and checks your technique at clinic visits. Ask for help at any point if the chart is unclear.
What happens if I miss a strut adjustment?
If you miss or make a wrong strut adjustment on a six-axis frame, contact the hospital the same day rather than trying to catch up. The team tells you how to correct the schedule safely, since a single missed turn is usually straightforward to fix when reported promptly.
Is six-axis frame correction painful?
Six-axis frame correction causes pain after the operation and a mild stretching feeling with some strut turns. Pain relief is planned with you and adjusted at each review. Pain that keeps rising, or numbness in the foot, is a reason to contact the hospital.
How is a hexapod frame different from an Ilizarov frame?
A hexapod frame uses six angled struts guided by computer planning to correct several planes of deformity at once, while a traditional Ilizarov-type circular frame uses hinges and rods that are set for each plane of correction. Both hold the bone with rings, wires and pins. Your surgeon chooses the frame that suits your deformity.
Can children have six-axis frame correction?
Children and teenagers can have six-axis frame correction for conditions such as Blount's disease or deformity after a growth-plate injury. Growth changes the plan, so treatment is decided together with pediatric orthopedics, and some children are better suited to guided growth instead.
Is six-axis frame correction covered by insurance?
Six-axis frame correction for deformity caused by injury or a medical condition is usually considered medically necessary, and most UAE insurance plans consider it with pre-approval. The frame may fall under a separate limit. Call Dar Al Kamal Hospital, Sharjah on 06 599 7777 for help with approval.
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