SUCCESS AND APPLICATION OF TAYLOR-SPATIAL FRAMES FOR PAEDIATRIC LOWER LIMB LENGTHENING AND ANGULAR CORRECTION.

Abstract

The Taylor-Spatial fame is increasingly being used for complex corrective surgery. The frame and SPATIAL FRAME.COM internet software are powerful surgical tools. There are few paediatric cases in the literature. We present the results from The Royal Orthopaedic Hospital, Birmingham.

All consecutive patients having treatment with Taylor-Spatial Frames over a 3 year period were enrolled in the trial. All patients under 18 were included. The frames were applied to treat angular deformities and leg length discrepancies. The conditions included Blounts disease, post meningio-coccal septicemia, femoral growth arrest, fibular hemimelia and Olliers disease.

Seventeen frames were applied to thirteen patients. The average age was 9.3 (2–17). All radiographs were reviewed and the deformities recorded to provide reference for the correction. We recorded angulation and translation in three planes; anteroposterior, lateral and axial. This data was input to SPATIAL-FRAME.COM, the strut length changes were calculated and printed out. Osteotomies were performed depending on the pathology if necessary. The patients did not start the correction protocol until 5 days post-operatively. The average correction time was 28 days (5–80) All frames were left in situ until 3 corticies were visible in the regenerate. We recorded patient satisfaction, deformity correction, infection and bony union rates.

All frames provided full correction to within normal anatomical ranges, there were no cases of deep infection. 3 Superficial pin site infections were recorded and swabs confirmed staph aureus. Patients were very satisfied overall. One patient with bilateral Blounts disease had a gradual reoccurrence of the deformity after full correction initially. 1 case required bone grafting to improve regenerate production. Interestingly he had been taking anti-inflammatories. All cases achieved bony union.