Limb lengthening combined with deformity correction in children with the Taylor Spatial Frame.
It is difficult to replicate the regular rate and rhythm described by Ilizarov while lengthening with the Taylor Spatial Frame. The purpose of the study was to examine whether this breach of Ilizarov's principles has any deleterious effect on the ability of children to make healthy regenerate bone. A retrospective case-control study was performed comparing pediatric patients undergoing primarily lengthening with Taylor Spatial Frame rings and struts, and patients undergoing lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Fifteen patients had primarily lengthening with Taylor Spatial Frame rings and struts, and six patients had lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Statistically, there was no significant difference between the two groups in terms of age, latency, pre-operative bone length percentage, and average length gained. The lengthening index for the strut group (1.79 months/cm) was significantly different from the clicker group (1.33 months/cm) with P=0.012. For a pediatric patient with lower extremity long bone deformities in multiple planes, the Taylor Spatial Frame is an excellent option. However, the surgeon should anticipate a slightly longer duration of treatment with the Taylor Spatial Frame compared to Ilizarov frames and plan his/her fixation accordingly. For the straightforward lengthening of pediatric long bones without significant concomitant deformity, our results indicate that the Ilizarov method appears to be superior to the Taylor Spatial Frame struts and should still be considered the gold standard.
Iobst
Christopher
C
Department of Orthopedic Surgery, Miami Children's Hospital, Miami, Florida 33155, USA. christopher.iobst@mch.com
D001852:Bone Lengthening / Q000295:instrumentation* / Q000379:methods; D016022:Case-Control Studies; D002648:Child; D004867:Equipment Design; D004869:Equipment Safety; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery; D038061:Lower Extremity Deformities, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome