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External fixation has become the most accurate and least invasive method for deformity correction. Its principal drawbacks are inconvenience, discomfort, and pin-site problems. In contrast, internal fixation is more invasive and less accurate. We have developed a method called fixator-assisted nailing (FAN) in which a temporary external fixator is applied during surgery to acutely correct the deformity. Once the correction has been adjusted to the exact alignment desired and confirmed using the malalignment test on intraoperative radiographs, an intramedullary nail is inserted to maintain the correction. The external fixator is then removed in surgery. The patient benefits from the accuracy and adjustability of an external fixator and the convenience of an intramedullary nail.
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Paley et al. (1997) studied this question.
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