Abstract
The Taylor spatial frame (TSF) has been used commonly in children and young adults. Its use in the tibia is more extensively studied and applied than in the femur. We asked whether normal alignment can be achieved with accuracy during correction of femoral deformities while avoiding major complications in children and young adults. We retrospectively reviewed the clinical and radiographic records of 20 patients (22 limbs), ages 5.9 to 24.6 years, who underwent a TSF for femoral deformity. Etiology included a number of diagnoses of the pediatric age. Minimum followup was 4.5 months (mean, 15.7 months; range, 4.5–35 months). The mean time in frame was 6.2 months (range, 2.6–19 months). Frontal and sagittal plane deformities were corrected to within normal values. A mean limb lengthening of 4.9 cm (range, 1.5–9 cm) was performed in eight femora in seven of which the limb length discrepancy was a secondary concern. External fixation index in the lengthening subgroup was 2.2 months/cm. The 15 complications in 13 limbs included pin tract infection, knee stiffness, delayed union, skin irritation, and posterior knee subluxation. No complications occurred in nine limbs. Computer-assisted femoral deformity correction with six-axis deformity analysis and the TSF is an accurate and safe technique in children and young adults.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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References
Al-Sayyad MJ. Taylor Spatial Frame in the treatment of pediatric and adolescent tibial shaft fractures. J Pediatr Orthop. 2006;26:164–170.
Binski JC. Taylor Spatial Frame in acute fracture care. Techniques Orthop. 2002;17:173–184.
Eidelman M, Bialik V, Katzman A. Correction of deformities in children using the Taylor Spatial Frame. J Pediatr Orthop B. 2006;15:387–395.
Fadel M, Hosny G. The Taylor Spatial Frame for deformity correction in the lower limbs. Int Orthop. 2005;29:125–129.
Feldman DS, Madan SS, Koval KJ, van Bosse HJP, Bazzi J, Lehman WB. Correction of tibia vara with six-axis deformity analysis and the Taylor Spatial Frame. J Pediatr Orthop. 2003;23:387–391.
Feldman DS, Madan SS, Ruchelsman DE, Sala DA, Lehman WB. Accuracy of correction of tibia vara: acute versus gradual correction. J Pediatr Orthop. 2006;26:794–798.
Feldman DS, Shin SS, Madan S, Koval KJ. Correction of tibial malunion and nonunion with six-axis analysis deformity correction using the Taylor Spatial Frame. J Orthop Trauma. 2003;17:549–554.
Ilizarov GA. The Apparatus: Components and Biomechanical Principles of Application. In: Transosseous Osteosynthesis. Berlin, Germany: Springer; 1992:63–120.
Jones DC, Moseley CF. Subluxation of the knee as a complication of femoral lengthening by the Wagner technique. J Bone Joint Surg Br. 1985;67:33–35.
Lin H, Birch JG, Samchukov ML, Ashman RB. Computer assisted surgery planning for lower extremity deformity correction by the Ilizarov method. J Image Guid Surg. 1995;1:103–108.
Nakase T, Ohzono K, Araki N, Hiroshima K. A case of Paget’s disease treated by distraction osteogenesis. Clin Orthop Relat Res. 2006;451:279–282.
Nakase T, Ohzono K, Shimizu N, Yoshikawa H. Correction of severe post-traumatic deformities in the distal femur by distraction osteogenesis using Taylor Spatial Frame: a case report. Arch Orthop Trauma Surg. 2006;126:66–69.
Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res. 1990;250:81–104.
Paley D. Normal lower limb alignment and joint orientation. In: Paley D, ed. Principles of Deformity Correction. Berlin, Germany: Springer-Verlag; 2005:1.
Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A. Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clinic North Am. 1994;25:425–465.
Rogers MJ, McFadyen I, Livingstone JA, Monsell F, Jackson M, Atkins RM. Computer hexapod assisted orthopaedic surgery (CHAOS) in the correction of long bone fracture and deformity. J Orthop Trauma. 2007;21:337–342.
Seide K, Wolter D. Universal 3-dimensional correction and reposition with the ring fixator using the hexapod configuration [in German]. Unfallchirurg. 1996;99:422–424.
Seide K, Wolter D, Kortmann HR. Fracture reduction and deformity correction with the hexapod Ilizarov fixator. Clin Orthop Relat Res. 1999;363:186–195.
Sluga M, Pfeiffer M, Kotz R, Nehrer S. Lower limb deformities in children: two-stage correction using the Taylor Spatial Frame. J Pediatr Orthop B. 2003;12:123–128.
Spatialframe.com, Version 3.1™. Taylor Spatial Frame Web site. Available at: http://www.spatialframe.com. Accessed June 12, 2007.
Theis JC, Simpson H, Kenwright J. Correction of complex lower limb deformities by the Ilizarov technique: An audit of complications. J Orthop Surg (Hong Kong). 2000;8:67–71.
Velazquez RJ, Bell DF, Armstrong PF, Babyn P, Tibshirani R. Complications of use of the Ilizarov technique in the correction of limb deformities in children. J Bone Joint Surg Am. 1993;75:1148–1156.
Wagner H. Operative lengthening in the femur. Clin Orthop Relat Res. 1978;136:125–142.
Acknowledgments
We thank Jaime A. Gómez, MD, Matthew I. Stein, BS, and Harold J.P. van Bosse, MD, for their contributions to the study.
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One of the authors (DSF) has received research support from Smith & Nephew, Inc. (Memphis, TN).
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with the ethical principles of research.
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Marangoz, S., Feldman, D.S., Sala, D.A. et al. Femoral Deformity Correction in Children and Young Adults Using Taylor Spatial Frame. Clin Orthop Relat Res 466, 3018–3024 (2008). https://doi.org/10.1007/s11999-008-0490-2
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DOI: https://doi.org/10.1007/s11999-008-0490-2