Clinical value of the Taylor Spatial Frame: A comparison with the Ilizarov and Orthofix fixators

Abstract

Purpose Evaluation of the advantages and limitations of the Taylor Spatial Frame (TSF) with regard to the healing index (HI), distraction-consolidation time (DCT), accuracy of correction complications, and cost of the device. Methods Comparison of results with the traditional Ilizarov apparatus and a unilateral Orthofix fixator in a consecutive patient series with 135 bony deformity corrections. Results The HI did not differ significantly between all three fixators and was 57 days/cm for all patients. The DCT was significantly shorter for the TSF (148 days) compared to the Ilizarov fixator (204 days) and the Orthofix device (213 days). The accuracy of deformity correction was higher for the TSF than the other devices. The mean values of the measured angles after correction did not differ, but the variance of the results was the lowest. Also, the total rate of complications was considerably lower for the TSF. The Orthofix device showed a high rate of angular deformity during treatment, whereas both ring fixators had a relatively higher number of pin-related problems. Conclusions The findings in our patient series suggest the use of the Orthofix apparatus for simple lengthening over short to median distances and the Ilizarov device for the correction of simple bony deformities and pure lengthening over long distances. The TSF allows multiplanar corrections and lengthenings without complex modifications of the device. But, due to the remarkably higher costs, it has not yet been established as our routine device. Level of evidence Level IV-case series. Therapeutic Study-Investigating the Results of Treatment.

A comparative study of the correction of femoral deformity between the Ilizarov apparatus and Ortho-SUV frame

“…Simple deformities in most cases were presented by single shortening, in few cases there was single angulation and rotation. This corroborates other studies comparing other hexapods and traditional IA [3,11]. Dammerer et al compared results of deformity corrections performed with one of the most popular hexapods-the Taylor Spatial Frame (TSF)-versus traditional IA and the unilateral Orthofix fixator in a consecutive patient series with 135 bony deformity corrections [3].…”

“…The computer dependant external fixators are aimed to simplify correction of multiple deformities. Comparative studies turned out to be an appropriate instrument to elaborate the [2,3,10]. We wanted to evaluate the advantages and limitations of the new software based external fixator OSF.…”

“…In the current literature there are few studies which approve the advantages of other computer-dependant devices in comparison with IA [3,10]. However, there is still no study comparing OSF with IA.…”

Current concepts of leg lengthening

“…Though it avoids the bulk and multi-pin or -wire fixation of ring fixators, it does not prevent pin muscle transfixation, which is mainly an issue in case of femoral lengthening. The appealing ease of surgical application (percutaneous placement of 4-6 pins, mounting of the clamps and bar) contrasts with the cantilever design and eccentric load, which offer less mechanical control than ring constructs [49]. Monolateral fixation is often not able to withstand the muscle forces during excessive lengthenings [127].…”

“…There seems not to be a difference between femoral and tibial lengthenings, not between congenital and acquired problems but higher age, severity of deformity, unilateral fixation and amount of acute correction may have some additional negative impact [13,154]. The figures for complications according to Paley [22] are biased, since IRF and TSF are commonly used for more complex cases: they range from 46 to 72 % for external fixation [13,17,22], up to 60 % for LON [60], are around 29 % [16,49] for Albizzia nails, 31-50 % [51,55] for ISKD and 12.5-27 % [56,63] for Fitbone nails.…”