Abstract
Hexapod external fixators, allowing for multiaxial deformity correction and fracture treatment, have been on the market for more than 25 years. The recent increase in the number of hexapod circular external fixators establishes the need for an easy-to-access overview of the different systems. An overview of the current options is provided, and a comparison is made of seven common hexapod circular external fixators. Highlights of each system's hardware, software, and educational opportunities are provided. The information collected from the manufacturers of each system was carefully and objectively edited to fit the structure of the review without including any additional subjective comments or recommendations. The authors believe that the development of multiple systems has had a positive effect on this technology. Only two clinical retrospective studies were found comparing the results of different systems, and there seems to be a clear opportunity for collaborative, multi-center comparative studies. The authors recommend choosing one hexapod system that feels comfortable and fits patient demands prior to pursuing mastering several systems. Level of Evidence: Review; Level 4 Key Concepts•Technical advances have driven the development of multiple high-quality hexapod external fixator systems.•Surgeons should aim to master one system that fits their patient population before pursuing other systems.•High-volume surgeons and clinics should invest in trials that directly compare different hexapod external fixators.