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Objectives Multi‐planar external fixation has been used for the management of segmental tibial fractures with severe soft tissue injuries. However, fewer specialized studies have been reported. The primary aim of this study was to describe our experience of treating fractures of this type using the Taylor Spatial Frame and Ilizarov external fixation methods. Methods We retrospectively analyzed 33 patients with segmental tibial fracture treated at our institution between January 2016 and December 2020. The patients were divided into double Taylor Spatial Frame (D‐TSF) and Ilizarov groups based on the external fixation structure. Baseline demographic data included sex, age, injury side and cause, open or closed fracture, time from injury to surgery, complications, and external frame removal and fracture healing time. The hip–knee–ankle angle (HKA) was measured from preoperative, immediate postoperative, and final follow‐up full‐length X‐rays of bilateral lower limbs. We determined the degree of deviation in the HKA by calculating the difference between the measured angle and the ideal value of 180°; the absolute value was used to assess recovery of the lower limb force line. At the final follow‐up, Johner–Wruhs tibial fracture outcome criteria (J‐W TFOC) were used to classify the postoperative function of the affected limb as excellent, good, moderate, or poor. Count data were analyzed with the chi‐square test or Fisher's exact test; the Mann–Whitney U test was used for rank data. Results No statistically significant differences were observed between the two groups in terms of sex, age, side of injury, cause of injury, closed or open fracture, or time between injury and surgery, which indicates that the groups were comparable (p > 0.05). A statistically significant difference was observed in external frame removal and fracture healing time between the D‐TSF and Ilizarov groups (36.24 ± 8.34 vs 45.42 ± 10.21 weeks, p = 0.009; 33.33 ± 8.21 vs 42.00 ± 9.78 weeks, p = 0.011). The Johner–Wruhs criteria were used to assess the function of the affected limb, the D‐TSF group performed better in correcting the lower limb force line than the Ilizarov group. A statistically significant difference in terms of excellent ratings was observed between the two groups (18/2/1/0 vs 5/5/1/1, p = 0.010). Postoperative follow‐up X‐rays demonstrated a significant improvement in the HKA in both groups immediately after surgery and at the final follow‐up compared to the angle before surgery. At the final follow‐up, a statistically significant difference was observed in the degree of deviation in the HKA between the two groups (1.58° ± 0.84° vs 2.37° ± 1.00°, p = 0.023). Conclusion The D‐TSF treatment is associated with minimal secondary damage to soft tissue, a straightforward and minimally invasive procedure, multiplanar stable fracture fixation, and optimization of fracture alignment and lower limb force lines, therefore, it is highly effective therapeutic option for segmental tibial fracture.

Objective Bone transport has become the gold standard for treating large segmental tibial bone defects. The technique for application the Ilizarov circular fixator (ICF) has a long learning curve and is associated with many complications. There are few clinical studies on bone transport via the Taylor spatial frame (TSF). The main purpose of this study was to compare the radiological and clinical and outcomes of bone transport by using the TSF and the ICF. Methods There were 62 patients included in this retrospective study from June 2011 to June 2021 and distributed to two groups according to the fixation method: a TSF group consisting of 30 patients and an ICF group consisting of 32 patients. Demographic information, surgical duration, external fixation times, external fixation index, final radiographic results, complications, and clinical outcomes were recorded and examined. The clinical outcomes were assessed using the ASAMI criteria during the most recent clinical visit. Then, statistical analysis such as independent‐samples t tests or chi‐Square test was performed. Results The mean surgical duration in the TSF group was 93.8 ± 7.3 min, which was shorter than that in the ICF group (109.8 ± 1.4 min) (p 0.05). The external fixation index was 1.4 ± 0.2 m/cm and 1.5 ± 0.1 m/cm in the two groups. Moreover, there was no significant difference between the two groups. At the last follow‐up visit, the medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) in the TSF group were 88.1 ± 12.1° and 80.9 ± 1.3°, respectively. The MPTA and PPTA in the ICF group were 84.4 ± 2.4° and 76.2 ± 1.9°, respectively. There were statistically significant differences between the two groups (all p 0.05). Conclusion No statistically significant difference was found in clinical outcomes between the use of Taylor spatial frame and Ilizarov circular fixator for treating large segmental tibial bone defects. However, TSF is a shorter and simpler procedure that causes fewer complications and improves limb alignment.

Background: Deformity of long bones of lower limb leads to frequent gait and joint problems, in addition to the esthetic problems. Correction of such deformities proves to be a challenge due to spatial and soft-tissue considerations. Taylor Spatial Frame (TSF) and Ortho-SUV Frame (SUV) are two six axis correction devices which utilize the Ilizarov methods and allow easier correction of complex deformities. This study was performed to compare the efficacy of TSF and SUV for correction of lower limb long bone deformities. Materials and Methods: The Study was held at Sir Ganga Ram Hospital, New Delhi between January 2015 and November 2019. Twenty patients were included for each correction group. Assessment of correction was done in terms of rate and accuracy of deformity correction, lengthening index, total lengthening achieved, time in frame, assessment of ability to perform Activities of Daily Living, functional outcome using Association for the Study and Application of the Method of Ilizarov (ASAMI) score, and complications during treatment. Results: Both groups showed excellent correction of deformity in all planes and good functional outcomes. TSF group showed lesser incidence of joint stiffness as well as a shorter time in Frame. Pin site infection was the most common complication followed by major residual deformity. Conclusion: Both TSF and SUV provide excellent outcome in correction of complex spatial deformities of lower limb with high accuracy and good functional outcome. The TSF provides an advantage over SUV with reduced time in Frame, lesser joint stiffness and increased patient compatibility due to smaller frame size and reduced bulk as compared to SUV.

Background: The Taylor Spatial Frame [TSF] is a circular external fixation system that attaches through screws and uses the same principles of correction as the Ilizarov device.Aim of the work: To assess the Ilizarov-Taylor Spatial Frame in the correction of the Proximal tibial Deformities.Patients and Methods: The present study comprised a sample of 15 patients, with a total of 20 tibiae, who underwent surgical tibial osteotomy for the purpose of correcting proximal tibial deformities by using the TSF. According to the treatment goal, patients were grouped into: group 1; mechanical axis deviation [MAD] center within 5 mm medial or lateral, group 2; MAD overcorrection from 6 mm to 12 mm medial or lateral, and group 3; MAD improvement with femoral origin residual deformity.Results: For patients with a goal of a MAD central [group 1], tibial origin varus deformity with preoperative average MAD of 48 mm medial to the midline, this improved to a range of 5 mm medial and 5 mm lateral to midline. For patient with tibial and femoral origins varus deformity and with preoperative MAD 104 mm medial to midline, this improved to 2 mm medial to midline. Statistical analysis for all proximal tibial angles and MAD showed significant improvement with P value < 0.05. The most common complication encountered was pin site infection. Six patients [30%] complained from superficial wire site infection that improved with wire removal in the outpatient clinic.Conclusion: The TSF can be used to treat severe tibial abnormalities with minimal risk of complications.

Abstract Background The Taylor Spatial Frame (TSF) has been widely used for tibial fracture. However, traditional radiographic measurement method is complicated and the reduction accuracy is affected by various factors. The purpose of this study was to propose a new marker- three dimensional (3D) measurement method and determine the differences of reduction outcomes, if any, between marker-3D measurement method and traditional radiographic measurement in the TSF treatment. Methods Forty-one patients with tibial fracture treated by TSF in our institution were retrospectively analyzed from January 2016 to June 2019, including 21 patients in the marker-3D measurement group (experimental group) and 20 patients in the traditional radiographic measurement group (control group). In the experimental group, 3D reconstruction with 6 markers installed on the TSF was performed to determine the electronic prescription. In the control group, the anteroposterior (AP) and lateral radiographs were performed for the traditional parameter measurements. The effectiveness was evaluated by the residual displacement deformity (RDD) and residual angle deformity (RAD) in the coronal and sagittal plane, according to the AP and lateral X-rays after reduction. Results All patients achieved functional reduction. The residual RDD in AP view was 0.5 (0, 1.72) mm in experimental group and 1.74 (0.43, 3.67) mm in control group. The residual RAD in AP view was 0 (0, 1.25) ° in experimental group and 1.25 (0.62, 1.95) °in control group. As for the lateral view, the RDD was 0 (0, 1.22) mm in experimental group and 2.02 (0, 3.74) mm in control group, the RAD was 0 (0, 0) ° in experimental group and 1.42 (0, 1.93) ° in control group. Significant differences in all above comparisons were observed between the two groups (AP view RDD: P = 0.024, RAD: P = 0.020; Lateral view RDD: P = 0.016, RAD: P = 0.004). Conclusions The present study introduced a marker-3D measurement method to complement the current TSF treatment. This method avoids the manual measurement error and improves the accuracy of fracture reduction, providing potential advantages of bone healing and function rehabilitation.

Objective: Bone transport has become the gold standard for treating large segmental tibial bone defects. The technique for application the Ilizarov circular fixator (ICF) has a long learning curve and is associated with many complications. There are few clinical studies on bone transport via the Taylor spatial frame (TSF). The main purpose of this study was to compare the radiological and clinical and outcomes of bone transport by using the TSF and the ICF. Methods: There were 62 patients included in this retrospective study from June 2011 to June 2021 and distributed to two groups according to the fixation method: a TSF group consisting of 30 patients and an ICF group consisting of 32 patients. Demographic information, surgical duration, external fixation times, external fixation index, final radiographic results, complications, and clinical outcomes were recorded and examined. The clinical outcomes were assessed using the ASAMI criteria during the most recent clinical visit. Then, statistical analysis such as independent‐samples t tests or chi‐Square test was performed. Results: The mean surgical duration in the TSF group was 93.8 ± 7.3 min, which was shorter than that in the ICF group (109.8 ± 1.4 min) (p < 0.05). Compared to the ICF group (10.2 ± 2.0 months), the TSF group (9.7 ± 1.8 months) had a shorter average external fixation time (p > 0.05). The external fixation index was 1.4 ± 0.2 m/cm and 1.5 ± 0.1 m/cm in the two groups. Moreover, there was no significant difference between the two groups. At the last follow‐up visit, the medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) in the TSF group were 88.1 ± 12.1° and 80.9 ± 1.3°, respectively. The MPTA and PPTA in the ICF group were 84.4 ± 2.4° and 76.2 ± 1.9°, respectively. There were statistically significant differences between the two groups (all p < 0.05). The complication rate was 50% in the TSF group and 75% in the ICF group. Moreover, the ASAMI score between the two groups was no statistically significant difference (p > 0.05). Conclusion: No statistically significant difference was found in clinical outcomes between the use of Taylor spatial frame and Ilizarov circular fixator for treating large segmental tibial bone defects. However, TSF is a shorter and simpler procedure that causes fewer complications and improves limb alignment. [ABSTRACT FROM AUTHOR]

Objectives: Multi‐planar external fixation has been used for the management of segmental tibial fractures with severe soft tissue injuries. However, fewer specialized studies have been reported. The primary aim of this study was to describe our experience of treating fractures of this type using the Taylor Spatial Frame and Ilizarov external fixation methods. Methods: We retrospectively analyzed 33 patients with segmental tibial fracture treated at our institution between January 2016 and December 2020. The patients were divided into double Taylor Spatial Frame (D‐TSF) and Ilizarov groups based on the external fixation structure. Baseline demographic data included sex, age, injury side and cause, open or closed fracture, time from injury to surgery, complications, and external frame removal and fracture healing time. The hip–knee–ankle angle (HKA) was measured from preoperative, immediate postoperative, and final follow‐up full‐length X‐rays of bilateral lower limbs. We determined the degree of deviation in the HKA by calculating the difference between the measured angle and the ideal value of 180°; the absolute value was used to assess recovery of the lower limb force line. At the final follow‐up, Johner–Wruhs tibial fracture outcome criteria (J‐W TFOC) were used to classify the postoperative function of the affected limb as excellent, good, moderate, or poor. Count data were analyzed with the chi‐square test or Fisher's exact test; the Mann–Whitney U test was used for rank data. Results: No statistically significant differences were observed between the two groups in terms of sex, age, side of injury, cause of injury, closed or open fracture, or time between injury and surgery, which indicates that the groups were comparable (p > 0.05). A statistically significant difference was observed in external frame removal and fracture healing time between the D‐TSF and Ilizarov groups (36.24 ± 8.34 vs 45.42 ± 10.21 weeks, p = 0.009; 33.33 ± 8.21 vs 42.00 ± 9.78 weeks, p = 0.011). The Johner–Wruhs criteria were used to assess the function of the affected limb, the D‐TSF group performed better in correcting the lower limb force line than the Ilizarov group. A statistically significant difference in terms of excellent ratings was observed between the two groups (18/2/1/0 vs 5/5/1/1, p = 0.010). Postoperative follow‐up X‐rays demonstrated a significant improvement in the HKA in both groups immediately after surgery and at the final follow‐up compared to the angle before surgery. At the final follow‐up, a statistically significant difference was observed in the degree of deviation in the HKA between the two groups (1.58° ± 0.84° vs 2.37° ± 1.00°, p = 0.023). Conclusion: The D‐TSF treatment is associated with minimal secondary damage to soft tissue, a straightforward and minimally invasive procedure, multiplanar stable fracture fixation, and optimization of fracture alignment and lower limb force lines, therefore, it is highly effective therapeutic option for segmental tibial fracture. [ABSTRACT FROM AUTHOR]

Abstract Aim The correction accuracy of the Taylor Spatial Frame (TSF) fixator depends considerably on the precise determination of the mounting parameters (MP). Incorrect parameters result in secondary deformities that require subsequent corrections. Different techniques have been described to improve the precision of MP measurement, although exact calculation is reportedly impossible radiologically. The aim of this study was to investigate the accuracy of intraoperative and postoperative radiographic measurement methods compared to direct MP measurement from TSF bone mounting. Methods A tibial Sawbone® model was established with different origins and reference ring positions. First, reference MPs for each origin were measured directly on the frame and bone using a calibrated, digital vernier calliper. In total 150 MPs measured with three different radiographic measurement techniques were compared to the reference MPs: digital radiographic measurements were performed using soft-copy PACS images without (method A) and with (method B) calibration and calibrated image intensifier images (method C). Results MPs measured from a non-calibrated X-ray image (method A) showed the highest variance compared to the reference MPs. A greater distance between the origin and the reference ring corresponded to less accurate MP measurements with method A. However, the MPs measured from calibrated X-ray images (method B) and calibrated image intensifier images (method C) were intercomparable (p = 0.226) and showed only minor differences compared to the reference values but significant differences to method A (p

Context: The management of multiapical and multidirectional deformities of the proximal tibia is still a challenging task with acute correction. The Taylor spatial frame (TSF) enables gradual correction in all planes. Aims: The study investigated the accuracy of correction for multiplanar proximal tibial deformities which had performed with the preassembled TSF. The complications and functional outcome were investigated. Settings and Design: Retrospectively, we compared the parameters of proximal tibial angles before and after using the preassembled TSF frame technique for correction. We used the mechanical axis deviation (MAD), medial proximal tibial angle (MPTA), posterior proximal tibial angle (PPTA), and tibial rotation as reference parameters for accuracy judgment. The deformities were divided into three main planes, each plane subdivided by two directions of angulations. Subjects and Methods: The study included 15 patients (20 tibiae), who underwent a tibial osteotomy surgery after obtaining informed consent for deformity correction using the TSF (Smith and Nephew, Memphis, TN, USA) between June 2016 and May 2018. Results: The three-plane deformities experienced an accurate correction of MAD. MPTA and PPTA were accurately corrected in patients with coronal and sagittal plane deformities, respectively. Rotational deformities were corrected to a satisfactory degree of accuracy in all cases. TSF correction for multiplanar proximal tibial deformities achieved an excellent result regarding functional outcome. Conclusions: Gradual correction for multiplanar proximal tibial deformities with the TSF is accurate, simple and with few complications.

The introduction of Taylor Spatial Frame (TSF) in clinical practice allows for unique capabilities in long bone deformity corrections; however, a comprehensive understanding of its mechanical characteristics and their impact on callus formation at the osteotomy site is still unclear. The current study is concerned with the clinical application of TSF in high tibial osteotomy (HTO) and the mechanical testing of this device. Fifty-five (55) patients with symptomatic medial compartment knee osteoarthritis and varus deformity underwent open-wedge HTO with the use of TSF and were prospectively monitored with regard to callus formation pattern at the site of osteotomy. Clinical evaluation revealed that the callus formation pattern was eccentric in all patients. In addition, the experimental results from mechanical testing of a clinically relevant TSF configuration indicate, that vertical deflection of the upper bone part during weight-bearing is accompanied by a rotation of the bone axis, which acts in the same direction to the rotation applied during the clinical correction process. The complementary contributions of the deformity correction process and the mechanical response of the TSF under compressive loads, lead to asymmetric gap closure, which promotes the eccentric callus formation in the osteotomy site. The study provides useful information for clinical decision-making regarding callus formation process when TSF external fixator is applied in HTOs.

Background: U-osteotomy with Taylor Spatial Frame correction is a rarely reported treatment method particularly well-suited for severe rigid equinus deformity in adults. The purpose of this study was to evaluate the effectiveness and efficacy of deformity correction and clinical outcome using this technique. Methods: We present a retrospective review of 30 feet in 26 patients who received U-osteotomy with Taylor Spatial Frame. Radiologic outcomes were measured using the anterior tibiotalar angle (TTA) with conventional weightbearing radiographs. Functional assessments included American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores and patient satisfaction using Likert scale. Results: The etiology included trauma (9), neglected or relapsed clubfoot (6), spina bifida (5), poliomyelitis (4), Charcot-Marie-Tooth disease (4), and iatrogenic (2). All patients had equinus deformity with TTA more than 140 degrees (median 157.5, 141-177). There were varus deformity in 19 feet, limb length discrepancy in 6 legs, and genu procurvatum deformity in 2 legs. The duration of gradual correction was 53.6±13.5 days (33-73 days), and the external fixation time was 147.8±25.2 days (98-203 days). At last follow-up, TTA in all patients improved significantly (P <.001) to 113.5 degrees (111.8-116.0). All patients had plantigrade feet, except for 2 cases of residual mild equinovarus deformity, 2 cases of residual mild hindfoot varus deformity, 1 case of moderate hindfoot varus recurrence. The AOFAS scores significantly improved (P <.001) from 51.0 points (29.0-66.0) to 76.0 points (69.5-88.0). Eighteen patients were very satisfied, 6 patients were somewhat satisfied, and 2 patients were somewhat dissatisfied. Conclusion: Using minimally invasive U-osteotomy with Taylor Spatial Frame to gradually correct the adult severe rigid equinus deformity proved to be an effective and relatively safe method associated with high patient satisfaction rates. Level of Evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

Aim: Taylor spatial frame (TSF) is a kind of six-axis external fixator based on Stewart platform, which is widely used in the fields of trauma orthopaedics and orthopaedic reconstruction., Purpose: To reduce the irregular movement of TSF's moving platform during orthopaedic process and decrease the risk of complications caused by collision between bone and surrounding tissue., Method: We combine the kinematics solutions with the multi-objective genetic algorithm and ant colony optimization to get the optimal solution for adjustment of strut length and order. We conduct simulation and physical experiment of orthodontic process respectively to prove the effectiveness of our method., Result: After optimization, the average offset during a single adjustment is less than 1 mm, and the offset during the whole orthopaedic process is reduced by about 38.8%., Conclusion: It demonstrates that our method can effectively reduce the offset of moving platform while ensuring orthopaedic accuracy., (© 2023 John Wiley & Sons Ltd.)

Introduction: Tibial osteomyelitis can follow open fractures with bacteria colonising the wound and persisting through biofilm and sequestrum formation. The treatment is complex, requiring eradication through debridement before limb reconstruction, for which the Taylor spatial frame (TSF) is one option. This study evaluates patient outcomes after reconstruction and identifies factors associated with post-operative complications., Materials and Methods: Fifty-one cases of tibial osteomyelitis were treated by the Ilizarov technique from 2015 to 2021 at a major trauma centre. Bacterial samples and treatment factors were assessed. Patient outcomes were complication rates and time to bony union. Complications were expressed as odds-ratios (OR) with 95% confidence intervals. Linear regression was used to assess factors associated with time to union., Results: The mean follow-up was 24.1 months with the mean time to radiological union being 11 months. Post-operative complications were noted in 76.5% of patients with pin-site infections most common (52.9%), followed by fracture malunion (29.4%). Smoking was associated with increased fracture malunion (OR = 4.148, 95% confidence Interval [1.13-15.18], p = 0.031). The time to union was positively associated with complications, age and time to full weight-bearing (FWB). All other measured factors were found not significant., Conclusion: Tibial osteomyelitis is treated reliably by debridement and reconstruction using the Ilizarov technique using a TSF application. The most common complication was pin-site infection. Optimising patients through cessation of smoking and encouraging post-operative weight-bearing can reduce the complication rate and improve time to union., Clinical Significance: The Ilizarov technique using a TSF can treat significant deformities that result from the management of tibial osteomyelitis., How to Cite This Article: Geetala R, Zhang J, Maghsoudi D, et al . The Use of the Taylor Spatial Frame in Treating Tibial Osteomyelitis Following Traumatic Tibial Fracture. Strategies Trauma Limb Reconstr 2024;19(1):32-35., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2024; The Author(s).)

Background Multiplanar knee deformity needs correction in different axes; this can be achieved by the Ilizarov system, which utilizes the hinges and translation mechanism; this needs an effort or orientation and gradual correction. The Taylor spatial frame (TSF) fixator solves this problems; it consist of two rings or partial rings connecting by six telescopic struts at special universal joints. Patients and methods The study included six patients with complex post-traumatic knee deformity. They had genu varus, recurvatum, and shortening; two female individuals and four male individuals, with an age range from 16 to 20 years comprised our study sample. The TSF was used for correction. Mean follow-up postoperatively lasted for 10 months. All cases were assisted clinically, radiologically, and by the Lysholm and the Oxford knee scores. Result All patients' knee deformities were corrected by application of TSF. All patients are very satisfied; the Lysholm knee score improved from 55 to 90%. One patient has a 5° recurvatum which was compensated postoperatively without any complications. There were no leg length discrepancies. Conclusion The TSF fixator was able to correct a six-axes deformity and also leg length discrepancies by adjusting only strut lengths; one ring can be repositioned with respect to the other ring.

Aims: Severe infantile Blount's disease can result in a challenging multiplanar deformity of the proximal tibia with intra-articular and metaphyseal components. We describe our results using the Taylor's spatial frame (TSF) for acute tibial hemiplateau elevation combined with gradual metaphyseal correction in patients with severe infantile Blount's disease with an associated physeal bony bar. Patients and Methods: Eight patients (ten knees) underwent tibial hemiplateau elevation and metaphyseal correction from 2012 to 2016. We undertook a retrospective case note and radiographic review of clinical and radiographic outcomes. The mean age at the time of surgery of was 11.7 years and the mean length of follow-up was 18.2 months. Results: Improvement in radiographic parameters was seen in all patients. The mean tibiofemoral angle improved from −28.3° to −5.9° postoperatively. The angle between femoral condyles and the tibial shaft improved from the mean of 56.3° to 90.3°. The joint depression angle was also seen to improve from the mean 47.4° to 9.8°. No significant complications were seen. Conclusion: This technique is effective in correcting the complex deformity encountered in severe infantile Blount's disease. Use of the TSF may provide certain advantages in comparison to previously described approaches.

This study was to report the comparison of outcomes between Ilizarov ring fixator (IRF) and Taylor Spatial Frame® (Smith & Nephew, Memphis, Tenn.; TSF) in terms of the effectiveness of ankle-foot deformities correction, follow-up results, and complications. Fourteen patients with ankle-foot deformities were corrected using circular external fixation (IRF group = 7 patients; TSF group = 7 patients) and related procedures. Baseline data and treatment variables were recorded. The patients’ mean age was 42.9 years. Mean follow-up time was 6.5 months. Most common cause of deformity/traumatic condition was posttraumatic equinus. There were successful results in 8 patients (57.1%), partial successful results in 5 patients (35.7%), and revision-needed in 1 patient (7.1%). TSF group demonstrated significantly higher rate of successful results than IRF group (P=0.033). A trend of lower complication rate was found in TSF group (P=0.286). Deformity corrections using TSF provided significantly better clinical scores and higher rate of successful outcome than conventional IRF.

Aim: Bone transport is a beneficial reconstructive method for bone defects caused by infected non-unions or bone tumours. The Taylor Spatial Frame (TSF) is a three-dimensional corrective external fixator that can be used to achieve bone transport and correct any residual deformities easily at any time. This study reports the results of bone transport using TSF., Materials and Methods: This is a retrospective study of ten patients who underwent bone transport using the TSF. The mean age was 32.3 years; the femur was affected in one case and the lower leg in nine. Bone defects were due to infected non-unions in seven cases and bone tumours in three. The duration of external fixation, bone transport distance, distraction index (DI), alignment at the end of correction, leg length discrepancy, and complications were investigated., Results: The average bone transport distance was 76.0 mm. The external fixation period averaged 367 days with the DI at 20.8 days/cm. Deformity at the docking site was assessed to have an average 2.6° deformity and 2.0 mm translation in the frontal view, as well as 3.3° deformity and 3.7 mm translation in the lateral view. The mean leg length discrepancy was 10.9 mm and the percentage of the mechanical axis (%MA) was 40.6%. Four patients underwent plate conversion after correction and two required additional surgery for non-union at the docking site. Bone union was achieved in all patients and there was no reaggravation of infection or tumour recurrence., Conclusion: The TSF allowed for the correction of deformities and translations that occurred during bone transport giving excellent results. However, as with bone transport using this or other devices, additional procedures are often needed to obtain consolidation or docking site union., How to Cite This Article: Shimokawa K, Matsubara H, Hikichi T, et al . Bone Transport with the Taylor Spatial Frame Technique: A Case Series. Strategies Trauma Limb Reconstr 2023;18(2):117-122., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Background. High tibial osteotomy (HTO) is used to treat medial degeneration of the osteoarthritis (OA) knee. However, shortcomings still exist in the current procedure, like unprecise creation, inability to correct knee rotation, and internal fixed failure. Here, we reported a novel procedure: patient-specific 3D-printed plates for opening wedge high tibial osteotomy (OWHTO) combined with Taylor spatial frame (TSF). The detailed technique was described, and the clinical outcomes were evaluated. Methods. We prospectively evaluate outcomes of patient-specific 3D-printed plates for OWHTO with use of TSF in 25 patients with knee OA and varus alignment. Postoperative efficacy was evaluated using the HSS knee score, pain visual simulation score (VAS), and knee joint motion (ROM), and lower limb alignment was evaluated by measuring femorotibial angle (FTA) and hip-knee-ankle (HKA). Results and Conclusion. All patients did not experience complications such as wound infection, nerve damage, or bone amputation. 25 patients were followed up for 6–18 months. The bony union at bone amputation was achieved in 3 months after surgery, and the pain symptoms were significantly alleviated or disappeared. The VAS score was significantly reduced in 6 months after surgery compared with preoperative; the HSSS score was significantly added in 6 months after surgery compared with preoperative. The ROM of knee joint increased significantly 6 months after operation compared with that before operation, and the difference was statically significant (P

Abstract Background Multi-drug-resistant bacteria (e.g. Carbapenem-resistant Acinetobacter baumannii, extended-spectrum betalactamase or carbapenemase-producing enterobacteriaceae) are emerging in early-onset infections. So far, there is no report describing the eradication of these bacteria in a osseous infection of an open proximal tibial fracture in combination with the hexapod technology to address both osseous consolidation and closed drop foot correction. Case presentation After sustaining a proximal tibial fracture (Gustilo 3B), a 41-year-old man was primarily treated with open reduction and internal fixation by a locking plate and split-thickness skin graft in the home country. At the time of admission to our hospital there was a significant anterolateral soft tissue defect covered with an already-necrotic split-thickness graft and suspicious secretion. CAT and MRI scans revealed no signs of osseous healing, intramedullary distinctive osteomyelitis, as well as a large abscess zone in the dorsal compartment. Multiple wound smears showed multi-drug-resistant bacteria: Acinetobacter baumannii (Carbapenem resistant) as well as Enterobacter cloacae complex (AmpC overexpression). After implant removal, excessive osseous and intramedullary debridements using the Reamer Irrigator Aspirator (RIA®) as well as initial negative pressure wound therapy were performed. Colistin hand-modelled chains and sticks were applied topically as well as an adjusted systemic antibiotic scheme was applied. After repetitive surgical interventions, the smears showed bacterial eradication and the patient underwent soft tissue reconstruction with a free vascularized latissimus dorsi muscle flap. External fixation was converted to a hexapod fixator (TSF®) to correct primary varus displacement, axial assignment and secure osseous healing. A second ring was mounted to address the fixed drop foot in a closed fashion without further intervention. At final follow-up, 12 months after trauma, the patient showed good functional recovery with osseous healing, intact soft tissue with satisfactory cosmetics and no signs of reinfection. Conclusions A multidisciplinary approach with orthopaedic surgeons for debridement, planning and establishing osseous and joint correction and consolidation, plastic surgeons for microvascular muscle flaps for soft tissue defect coverage as well as clinical microbiologists for the optimized anti-infective treatment is essential in these challenging rare cases. Level of evidence Level IV.