A Way Forward
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.
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).
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).
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.
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.
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