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This especially applies when the monolateral fixator is not exactly parallel to the mechanical axis.
The attachment to the test machine allowed a solely axial loading parallel to the mechanical axis of the composite bone.
If the elongation axis is not parallel to the mechanical axis, a minor deformity will occur during the gradual increase in length.
In theory, it is preferable to place the fixator rail parallel to the mechanical axis so that lengthening does not induce a displacement of this axis.
Nevertheless, we also have to take into consideration that placing the body of the fixator parallel to the mechanical axis will result in having more stress on the pin bone interface since the screws will not be inserted at right angles into the bone.
The use of an intramedullary tibial guide results in a less than ideal cut in a bowed tibia because aligning the intramedullary tibial guide parallel to the mechanical axis of the tibia is impossible [ 27].
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For this reason, other authors consider that the body of the fixator has to be placed in parallel with the mechanical axis, preventing the valgus and the medial translation during the lengthening, [6] as shown in Fig. 6.
The resection angle was adjusted to be perpendicular to the mechanical axis of the tibia in the coronal plane and to be parallel to the posterior slope of the original medial tibial plateau in the sagittal plane.
The resulting normal vector and the condylar axis are projected onto a plane that is orthogonal to the mechanical axis.
There is no controversy about the tibia, if the fixator must be implanted in parallel to the anatomical axis or the mechanical axis, since both are coincident [6].
A puncture test performed both perpendicularly and parallel to the long axis of the tubers was used and the mechanical resistance expressed by puncture force (N) and puncture energy (mJ).
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