Taylor spatial frame in the treatment of upper extremity conditions.
ABSTRACT Taylor spatial frame (TSF) is a modern multiplanar external fixator that combines ease of application and computer accuracy; it provides the capability of 1 to 6 axes of deformity correction sequentially or simultaneously by adjusting 6 connecting struts between 2 circular rings. Previous reports have documented the effectiveness of the TSF in acute fracture care, nonunion treatment, and in bone lengthening and deformity correction in the lower extremity. To the authors' knowledge, no previous case series in the English literature have documented the use of the TSF in treating upper extremity conditions. Our experience with the use of this external fixator in the treatment of upper extremity length abnormality, angulation, and bone transport is summarized.
Over a period of 7 years, TSF was used in 12 patients with varying upper extremity pathologies that were collected from our prospective external fixator database. The classic TSF planning strategy was adopted and the TSF web-based program was used. All cases were followed for a minimum of 2 years. The database and radiographs were reviewed to obtain demographic data, malalignment parameters, final correction, time in the TSF, and complications.
Patients' ages ranged from 8 to 18 years. Eight humeral and 4 radial cases were identified. These included 4 cubitus varus and 1 cubitus valgus deformity, 1 neglected supracondylar fracture, 2 humeral nonunion, 2 radial malunion cases, and 1 radial shaft septic nonunion. Time in the TSF varied according to patient age and bone involved. Five patients had superficial pin site infections that resolved with oral antibiotics. Postoperatively mean final angulation on the anteroposterior radiograph was 1 degree (range, 0 to 5 degrees) and the mean final angulation on the lateral radiograph was 0.5 degrees (range, 0 to 2 degrees). Union of bone was achieved in all cases.
The TSF is an external fixator that can be successfully used as a treatment alternative for the definitive treatment of upper extremity conditions involving a deformity and or shortening or bone transport in the pediatric and adolescent patient population.
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ABSTRACT: A retrospective study of 63 patients with cubitus varus deformity following supracondylar fracture of the humerus was carried out in order to identify the causes of cubitus varus, to define the best method for prevention, and to evaluate the indications for and results of treatment of the established deformity. There was no evidence of growth disturbance in any of our patients after a mean follow-up of 5 years postfracture. Cubitus varus was found to be secondary to medial tilting of the distal fragment. Failure to recognize this initial or subsequent medial tilt during early treatment of the fracture was the major factor in the development of cubitus varus deformity, thus explaining the average delay in diagnosis of 6 to 10 weeks postfracture. Since all patients regained essentially normal use of the upper extremity after the fracture, cosmesis was the primary indication for corrective surgery. Fifteen supracondylar osteotomies are reported with 33% unsatisfactory results. Prevention of this deformity by careful clinical and radiological evaluation during initial treatment of the supracondylar fracture is emphasized.Journal of Pediatric Orthopaedics 02/1982; 2(5):539-46. · 1.16 Impact Factor
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ABSTRACT: Cubitus varus may occur after supracondylar humerus fractures. Poor fixation, however, complicates operative treatment of cubitus varus. We discuss the use of external fixation in the treatment of cubitus varus. Five patients had humeral osteotomies with external fixation. The preoperative humeroulnar angle (HUA) averaged -24.2 degrees. The immediate postoperative HUA averaged 12 degrees, and the final angle averaged 13 degrees. Duration of external fixation averaged 8.9 weeks. Complications were one transient radial neurapraxia, one superficial pin infection, and one keloid. No loss of correction or motion occurred with external fixation; we recommend external fixation as safe and effective.Journal of Pediatric Orthopaedics 01/1996; 16(5):597-601. · 1.16 Impact Factor