Article

Taylor spatial frame in the treatment of upper extremity conditions.

Department of Orthopaedic Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Journal of pediatric orthopedics (Impact Factor: 1.23). 03/2012; 32(2):169-78. DOI: 10.1097/BPO.0b013e3182471ae4
Source: PubMed

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.
Level IV.

0 Bookmarks
 · 
117 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die häufigsten Frakturen im Wachstumsalter betreffen die obere Extremität. Vor allem nach ellenbogengelenknahen Frakturen kommt es oft zu Komplikationen. Die Fugen um das Ellenbogengelenk sind am Längenwachstum nur mit 20% beteiligt und besitzen daher nur ein geringes Korrekturpotenzial. Auch die Möglichkeit der Spontankorrektur ist bereits mit dem 7. Lebensjahr ausgeschöpft. Die Konsequenzen einer unzureichend versorgten, ellenbogennahen Fraktur können den Patienten somit ein Leben lang begleiten. Für den behandelnden Chirurgen sind posttraumatische Fehlstellungen am kindlichen Ellenbogen eine Herausforderung. Häufig sind sie die Folge einer unzureichenden Primärtherapie und selten auf Wachstumsstörungen zurückzuführen. Die häufigste posttraumatische Fehlstellung ist der Cubitus varus, gefolgt vom Cubitus valgus. Beide Deformitäten können aus einer ungenügend behandelten suprakondylären Humerusfraktur, einer Condylus-radialis-Fraktur oder einer übersehenen Luxation des Radiusköpfchens resultieren.
    Der Orthopäde 01/2013; 42(1). · 0.51 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Most fractures during growth affect the upper extremities. Severe fractures with an increased number of complications are mainly localized beyond the elbow joint. Displaced fractures of the elbow joint have limited potential for spontaneous correction as the bones near the elbow joint account for only 20% of growth in length and the possibility of spontaneous correction is already exhausted at the age of 7. The consequences of inadequately reduced elbow fractures, therefore, may adversely affect a patient for his lifetime. Cubitus varus and valgus are the most common deformities following insufficiently treated supracondylar humerus fractures, fractures of the radial or dislocations of the radial head. Posttraumatic deformities of the elbow are usually the result of an insufficient primary therapy and rarely the result of growth disturbances. For the attending surgeon, posttraumatic deformities on a child's elbow are challenging.
    Der Orthopäde 01/2013; · 0.51 Impact Factor
  • The Journal of hand surgery 06/2013; · 1.33 Impact Factor