The use of the Taylor spatial frame in adolescent Blount's disease: Is fibular osteotomy necessary?

Abstract

Background The standard treatment of adolescent Blount disease includes proximal tibial osteotomy and osteotomy of the fibula. Some believe that the fibula should also be fixed to prevent migration and subluxation. The purpose of the current study was to examine the results of treatment of patients with adolescent tibia vara treated by tibial osteotomy and Taylor spatial frame (TSF) without fibular osteotomy. Methods Correction of deformities was performed on eight patients (ten tibias) with adolescent Blount disease using TSF. The fibula was not osteotomized in any patient and was not fixed in the last five patients. Results All patients had precise anatomical correction of deformities and no problems related to the fibula occurred during or after correction. Conclusion Based on our experience we believe that placement of the origin at the level of the proximal tibial fibular joint in conjunction with external fixation eliminates the need for fibular osteotomy and the potential morbidity of this procedure in patients with mild to moderate tibia vara.

Management of neglected Blount disease using double corrective tibia osteotomy and medial plateau elevation

“…In the same article, 100 % of the patients had problems with pin-site infection. The high incidence of this complication has been confirmed by other authors [16,17,19,23]. Leg lengthening was required in one of our cases, but the discrepancy existed before the double corrective osteotomy.…”

“…The use of the Ilizarov Frame [15][16][17], the Taylor Spatial Frame [18][19][20], and a Multi-Axial Correction external fixation system [21] are modern therapeutical options, although significantly more expensive than our procedure. These systems enable gradual correction [20], in contrast to our cases, for whom correction was imminent.…”

Intentional Deformation and Closure of Soft Tissue Defect in Open Tibial Fractures With a Taylor Spatial Frame—A Simple Technique

“…8,9,[21][22][23][24][25][26] Manner et al 27 compared IRFs and TSFs in correcting complex limb deformities and found TSF to be superior to IRF. Several studies confirm the accuracy of this method in trauma and developmental deformities.…”

Guided growth of the lower extremities

“…17 However, this report included patients with both infantile and adolescent Blount disease. Eidelman et al 23 reported eight patients with mild to moderate adolescent Blount disease who underwent successful anatomical correction using the TSF without a fibular osteotomy. Other studies have shown the TSF to be effective in the correction of Blount disease when combined with other procedures such as hemiplateau elevation and epiphysiodesis.…”

“…Although these two clinical entities prognostically cannot be compared, the treatment was successful in both patient populations. 23 18,19 TSF has been shown to perform comparably to an Ilizarov fixator in treating Blount disease.…”