Correction of simple and complex pediatric deformities using the Taylor-Spatial Frame.

Abstract

Correcting multiplanar lower-limb pediatric deformities requires complex and, in many cases, staged procedures. The Taylor-Spatial Frame (TSF) is a sophisticated external fixator system that can be used to treat simple to complex multiplanar and multiapical skeletal deformities. We describe its use in 53 children during the last 7 years in a variety of pathologies and demonstrate its ease of use and versatility. A review of medical and physiotherapy records, radiographs, and computed tomographic scans of all patients treated with a TSF between June 1999 and December 2005 at the Booth Hall Children's Hospital was conducted. Data recorded were etiology of deformity, sex, age, number of previous operations, preoperative deformity parameters, operative records and frame constructs, treatment regime, frame duration, follow-up protocol, posttreatment deformity, complications, and clinical and radiological outcome. Fifty-three patients between the ages of 12 months and 16 years (mean, 10.7 years) underwent correction programs for 55 limbs (44 tibia and 11 femurs). The etiology of deformity was congenital in 39 cases and acquired in 14. We were able to achieve an acceptable correction of deformity (leg length discrepancy <15 mm, angulation <5 degrees) in 52 limbs. A number of complications were encountered, which are discussed. We demonstrate its ease of use for both surgeon and patient and its versatility in a variety of pathologies. The advantages of the TSF system are many. It is a simple frame construct, and application is easy. The plan and execution are structured with precise end points; it is a single-stage correction and thus avoids frame modifications. Any residual deformity can be further corrected by use of the same frame. We conclude that the TSF is an effective and efficient way to correct a wide variety of simple and complex often obstinate pediatric limb deformities.