Objective: To evaluate the Taylor spatial frame (TSF) for primary
and definitive fixation of lower limb long-bone fractures in patients
with multiple traumatic injuries.
Design: Retrospective.
Setting: Level I trauma center.
Patients: Consecutive series of 52 patients, 57 fractures (25 femoral
and 32 tibial), treated between 2005 and 2009. Forty-nine fractures
(86%) were open. Injury Severity Score $16 for all patients.
Intervention: Fifty-four fractures (95%) underwent definitive
fixation with the TSF and 3 were treated primarily within 48 hours
of injury. In 22 cases (39%), fractures were acutely reduced with the
TSF, fixed to bone and the struts in sliding mode without further
adjustment, and in 35 cases (61%), the total residual deformity
correction program was undertaken.
Main Outcome Measure: Clinical and radiological.
Results: Complete union was obtained in 52 fractures (91%) without
additional surgery at an average of 29 weeks. Four nonunions and 1
delayed union occurred. Results based on Association for the Study
and Application of the Method of Ilizarov criteria: 74% excellent, 16%
good, 4% fair, and 7% poor for bone outcomes and 35% excellent,
47% good, and 18% fair for functional outcomes. Eighty-eight percent
of patients returned to preinjury work activities.
Conclusions: Primary and definitive fixation with the TSF is
effective. Advantages include continuity of device until union, reduced
risk of infection, early mobilization, restoration of primary defect
caused by bone loss, easy and accurate application, convertibility and
versatility compared with a monolateral fixator, and improved union
rate and range of motion for lower extremity long-bone fractures in
patients with multiple traumatic injuries. |
