The Taylor Spatial Frame (Smith & Nephew, Memphis, TN) is a powerful tool in providing gradual correction of deformity. The Taylor Spatial Frame has the potential to allow for very accurate corrections achieved over one or more schedules through the use of the software on www.spatialframe.com. The accuracy of the frame is contingent upon the input of precise parameters. The correction occurs about a virtual hinge in space called the origin. The location of the origin is defined by its spatial relationship to the reference ring. Mounting parameters are the measurements that define the location of the origin (virtual hinge). We present a simple practical method for obtaining mounting parameters during surgery using standard equipment.
BackgroundThe purpose of this study was to describe fractures sustained by children and to analyze the associated costs when a caretaker falls down stairs while holding a child.Materials and methodsBetween 2004 and 2012, 16 children who sustained a fracture after a fall down stairs while being carried by a caregiver were identified. Parents/caregivers were interviewed to see how the fall occurred, and a cost analysis was performed.ResultsThe average age of the patients was 14.5 months (7–51 months). The lower extremity was involved in 15 of 16 fractures, with 8 involving the femur. The majority were buckle fractures, but all diaphyseal femur fractures were spiral. Three patients required a reduction in the operating room. All fractures healed with cast immobilization. Five patients underwent skeletal surveys, as the treating physicians were concerned about potential child abuse. The average cost of treatment was $6785 (range $948–45,876). Detailed histories from the caregivers showed that they “missed a step” due to the child being carried in front of the caregiver, obscuring their vision.ConclusionsA fall in a caregiver’s arms while going down stairs can result in multiple orthopedic injuries. The costs of treating these injuries are not insignificant, and the suspicion of child abuse can be both costly and unnecessary in the case of a true accident. While descending the stairs with a child in their arms, the caregiver should hold the child to the side so as not to obscure their vision of the step with one arm, ideally holding the handrail with the other.Level of evidenceIV case series.
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