Taylor spatial frame in the treatment of open tibial shaft fractures

Abstract

Background:The Taylor spatial frame (TSF) is a modern multiplanar external fixator that combines the ease of application and computer accuracy in the reduction of fractures. A retrospective review of our prospective TSF database for the use of this device for treating open tibial fractures in pediatric, adolescent, and adult patients was carried out to determine the effectiveness and complications of TSF in the treatment of these fractures.Materials and Methods:Nineteen male patients with open tibial fractures were included. Of these fractures, 10 were Gustilo Type II, five were Gustilo Type IIIA (two had delayed primary closure and three had split thickness skin grafting), and four were Gustilo Type IIIB (all had rotational flaps). Twelve of our patients presented immediately to the emergency room, and the remaining seven cases presented at a mean of 3 months (range, 2.2-4.5 months) after the initial injury. The fractures were located in proximal third (n=1), proximal/middle junction (n=2), middle third (n=3), middle/distal junction (n=8), distal third (n=3), and segmental fractures (n=2). Patients were of an average age of 26 years (range, 6-45years). Mean duration of follow-up was 3.5 years.Results:All fractures healed over a mean of 25 weeks (range, 9-46 weeks). All were able to participate in the activities of daily living without any difficulty and most were involved in sports during the last follow-up. Postoperative complications included pin tract infection in 12 patients.Conclusion:The TSF is an effective definitive method of open tibial fracture care with the advantage of early mobilization, ease of soft tissue management through gradual fracture reduction, and the ability to postoperatively manipulate the fracture into excellent alignment.

Treatment of open fractures with a computer-assisted external fixator system without the use of fluoroscopy

“…There is no significant difference between these two treatment methods in fracture healing time, deep tissue infection, and osteomyelitis in open tibial and femoral fractures [ 13 ]. Traditional circular fixators need excellent preoperative planning and careful application [ 5 ]. Computer-assisted external fixation systems are based on Ilizarov principles and provide similar stability to that of Ilizarov-type external fixators with easier application.…”

“…Computer-assisted external fixation systems are based on Ilizarov principles and provide similar stability to that of Ilizarov-type external fixators with easier application. Nowadays, they are more commonly used in the treatment of open fractures [ 5 , 14 , 15 ]. This study presents the use of the Spider Frame in open fractures, and to our knowledge, is the first paper in the literature about this computer-assisted system.…”

“…Ilizarov presented his circular fixator concept, and many surgeons use these systems in the treatment of long bone open fractures [ 2 , 3 ]. A long learning curve, difficulties during applications, and the need for fluoroscopy during procedures are the main disadvantages [ 4 , 5 ]. It is possible to overcome these disadvantages with computer-assisted circular fixator systems [ 6 – 8 ].…”

Efficacy of 1 % silver sulphadiazine dressings in preventing infection of external fixation pin-tracks: a randomized study

“…Redness or tenderness near a pin (stage 1) or serous discharge (stage 2) or seropurulent or purulent discharge (stage 3) was taken as evidence of infection. The above classification set aside grades 4 and 5 of the Dahl classification [ 20 ] (4 = osteolysis requiring pin removal and 5 = ring sequestrum requiring debridement) which we presume are representative of a complicated infection. Swabs were taken from any pin-site with serous, seropurulent and purulent discharge for microscopy, culture and sensitivity.…”

Accuracy of a hexapod parallel robot kinematics based external fixator

“…Many studies in recent years have reported on the successful use of hexapod‐based external fixators in clinical practice for various indications. In some of these studies, the authors define the achieved clinical accuracy as the amount of remaining bone deformity (angulation and torsion in degrees, and translation in millimeters or percentage of dislocation) . In other studies, the standard joint angle system established by Paley and colleagues is used as the reference to report clinical accuracy .…”