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A Way Forward

10

Taylor Spatial Frame consists of two rings

and six telescopic struts with universal

joints. It is generally applied under general

anaesthesia. Post-operatively, the deformity

and frame parameters are entered into

web-based software, which then generates

a schedule of strut length changes (known

as ‘prescription’). Struts are adjusted every

day according to the ‘prescription’ to

achieve the desired correction. Duration

of frame treatment depends upon the

magnitude of deformity and shortening.

Generally, lengthening progresses at

1mm per day. After achieving the desired

correction and length, the frame is left in

place until the bone heals and matures.

Finally, the frame can be removed without

anaesthetic in the clinic.

Case 1.

Young professional footballer

sustained closed displaced fracture of tibia.

Within hours, he developed compartment

syndrome and needed emergency

fasciotomy. A monolateral external fixator

was applied initially but it failed to control

the alignment.Two ring TSF was applied

and the fracture was gradually reduced

to anatomical alignment. During the

treatment, he was allowed to weight bear

as tolerated, throughout the treatment.

Fracture united in 20 weeks (Fig 2).

Case 2.

19-year-old male sustained

compound communited fracture of tibia.

Initial management consisted of wound

debrediment, application of external

fixation and 3cm shortening of the

limb to close the wound. Nine months

post injury, tibia remains disjointed,

the leg is short. I applied a two level

TSF, compressed the non-union site

and commenced lengthening from

the proximal tibia. At the end of seven

months, tibia regained normal length

and non-union healed (Fig 3).

Case 3.

65-year-old lady presented

with severe foot deformity and frequent,

painful recurrent ulceration and infection

of the lateral border of the foot. She

was advised to undergo amputation,

but she refused.When I examined her,

the deformity was very stiff. I applied a

two lobe TSF after performing mid and

hind foot osteotomies and gradually

corrected the deformity. I achieved nearly

plantigrade foot in just under four weeks

and total duration in the frame was

approximately 24 weeks (Fig 4).

Taylor Spatial Frame, in conjunction

with Internet-based software, is a very

powerful tool in managing fractures,

non and malunion, deformities and

limb lengthening. Preoperative frame

assembly is minimal and fast, compared

to the standard Ilizarov system.The

computer generated ‘prescription’ is

patient-friendly and helps compliance

during the treatment.

Computer Assisted

Limb Deformity

Correction and Lengthening

mr om lahoti

Consultant Orthopaedic Surgeon – King’s College Hospital

The impact of computers and Internet is seen everywhere in our lives

and orthopaedic surgery is no exception. Computer assisted knee and

hip replacement surgery is gaining in popularity. Internet-based software,

integrated circular frame known as Taylor Spatial Frame, is becoming very

popular in the treatment of a variety of fractures, nonunion, malunion and

foot deformities. It gives surgeons the freedom to correct deformity in

any plane and of any magnitude, using the same two ring frame. It is 100%

accurate and the technique is minimally invasive in the majority of cases.

Contact details:

Tel: +44 (0) 20 7407 8252

Fax: +44 (0) 20 7015 9194

Areas of special interest: Hip,

knee, foot and ankle problems.

Images above – Fig 4

Fig 3

Fig 2

Fig 2

Fig 2