Salamehfix
Salamehfix 1 / SLDF hinged arc external fixator
A three-arc hinged external frame designed to lengthen the bone and correct an axial deviation in the same distraction — used by one surgeon and his team.
How it works
Salamehfix 1 (also called the SLDF system) is an external fixator designed by Prof. Ghassan Salameh — trained in external fixation at CITO in Moscow, the institute at the centre of the Soviet frame tradition — who operates with it himself. Instead of the closed rings of an Ilizarov frame it uses three small anterior arcs joined by hinged distraction rods, with pins entering the bone at several angles and levels. The hinges are the point: because the frame can angulate as it distracts, a bone can be lengthened and a bow or axial deviation straightened during the same treatment, and the design is intended to allow early mobility and full weight-bearing on the frame. In International Orthopaedics (2025) Salameh and Michael Schmidt reported 1,103 lower-limb reconstructions performed with the system between 2000 and 2024 — 640 of them combining lengthening with deformity correction, and 193 of them stature (cosmetic) lengthening. Mean lengthening across the series was 5.6 cm (range 2–18 cm) with a mean bone healing time of 260 days; the stature subgroup averaged 6.5 cm. That one paper is, so far, the entire published evidence base for the device.
At a glance
- Typical gain
- 5–8 cm
- Total recovery
- 24–52 weeks
- Distraction sites
- femur, tibia
- External hardware
- Yes
- Manufacturer
- Designed by Prof. Ghassan Salameh (Salamehfix / SLDF); later revisions marketed as Modified SLDF 4 and Salamehfix 3
- Status
- Regional
What this means for a patient
- ●Lengthening and axial correction in a single treatment, without a second procedure
- ●Hinged arc design intended for early mobility and full weight-bearing on the frame
- ●Frame geometry is customised to the patient and the deformity pattern
Trade-offs and risks
- ●External frame: pin-site care, infection risk and visible hardware for months
- ●Essentially a single-surgeon system — availability depends on one team
- ●Evidence is one retrospective, single-centre series reported by the device designer; the complication rate published for it (25 superficial pin-site infections, 9 contractures and 1 deep infection across 1,103 patients) is far lower than pin-site problem rates usually reported for external fixation, and has not been reproduced independently
1 verified clinic offering Salamehfix
Frequently asked questions
What is the Salamehfix fixator?
It is a hinged external fixator built from three small anterior arcs rather than full rings, designed by the orthopaedic surgeon Ghassan Salameh. The hinged rods let the surgeon lengthen a bone and correct an angular deformity at the same time.
How much evidence is there for it?
One peer-reviewed paper: Salameh G, Schmidt M, International Orthopaedics 2025;49(11):2599–2605 (PMID 40956411), a retrospective series of 1,103 patients treated between 2000 and 2024. It is the surgeon reporting on his own device, it has not yet been replicated by an independent team, and the reported complication rate is unusually low for frame-based lengthening.
Who offers Salamehfix lengthening?
Prof. Salameh, who developed the system and now works in Frankfurt am Main with Dr. Michael Schmidt of the OUZ Orthopädisches Zentrum. It is not a device you will find offered across a network of clinics.
Reading on Salamehfix
- Bow legs in adults — what correction really does, and what it does to your height
Straightening bowed legs adds millimetres, not inches — about 4 mm in the published data. What correction involves, and when lengthening is the answer.
This page is editorial reporting, not medical advice. Every patient anatomy is different — technique selection requires in-person consultation with a qualified surgeon.