The TAYLOR SPATIAL FRAME◊ External Fixator for deformity correction
The TAYLOR SPATIAL FRAME◊ External Fixator (TSF), is an external fixator used by orthopedic surgeons to treat fractures and deformities in the long bones - arms and legs - of both children and adults.
What is the TAYLOR SPATIAL FRAME?
TSF is an external fixator, meaning that it's worn outside the body. The body of the TSF is made up of two aluminum rings which go around the arm or leg and are connected to each other with six, independently operated telescoping rods called struts. The TSF device is attached to the patient through the skin with pins or wires which connect to the sections of bone your surgeon wants to move. Since each of the six struts can be lengthened or shortened as needed, the device is able to accurately move the bone sections into the correct alignment in six planes. Once the TSF is attached, your surgeon will input information about the specific bone deformity into a computer application. The software creates a prescription for strut adjustments designed to correct the deformity. These daily strut adjustments are made by the patient at home.
How does the TSF device work?
TSF works through a natural process called Distraction Osteogenesis (DO). Simply put, DO is the bone's way of regenerating itself to fill in the small space that occurs as sections are gently pulled apart, or distracted. In healthy tissue, the new bone can form at a rate of 1mm per day.1 What is really remarkable though, is how the body can also regenerate new blood vessels, nerves, muscle fibers and skin as the new bone grows and lengthens.
The new bone that forms in the regenerative phase is spongy and soft. Once the lengthening movements have been completed, the new bone starts to thicken, mineralize and become stronger. This phase is called the consolidation phase. A general rule of thumb is that consolidation takes twice as long as regeneration, however your surgeon will monitor your progression of bone formation through x-rays and at your clinic visits.
What patients can expect
Patients can expect at least two surgeries, one to attach the device and one to remove it. Once the device is attached, the patient will be responsible for making daily adjustments to the struts and following their rehabilitation program as laid out by their surgeon. As they make adjustments, the rings will gradually reposition and move the bones into normal alignment.
At certain points during the process, your surgeon will compare your current x-rays with your treatment plan to make sure your bones are healing properly and at an appropriate pace. While the severity of each patient's condition will dictate how long they have to undergo treatment, the typical treatment time is between 4 to 12 months.
The treatment recovery process
After completing your treatment, you will likely be required to wear a brace or cast to provide your bones with additional time to heal and strengthen. Initially, you may also have physical limitations and need to limit your activity. These limitations should fade in time and you will be left with bones and soft tissues that are normal in alignment, length, and function.
TSF works in harmony with your body's own natural biology2,3,4,5 by providing a structurally stable environment for bone to form, while you continue to move about and get on with life. Once TSF has done its job, it is removed leaving nothing behind only your own re-built bone.
Wearing a TSF is a temporary alteration to your life. The treatment process is a journey requiring commitment and courage, but it is a journey that definitely has a final destination. One of the best ways to prepare for the journey is to speak with someone who has gone through it. Your surgeon may be able to introduce you to someone who would be willing to talk to you about their experience and help you prepare for this temporary change to your lifestyle.
Here are some points to consider before you receive the TSF device:
Hospitalization: You should plan for a hospital stay of at least three to four days. Ask your surgeon for help in planning what to bring with you and what to expect.
Strut Adjustments: You must make the commitment to follow a schedule of daily fixator adjustments. These are needed during the lengthening/correction phase to achieve the planned results. Consider using the smart phone App iAdjust to help you manage your strut adjustment schedule.
Scheduling Considerations: Plan ahead now for the amount of time away from school or work, frequency of clinic visits, time of year and transportation issues you'll face. Your surgeon's clinic can assist you with making these plans.
Physical Limitations: Understand ahead of time what you will be able to do and won't be able to do. Talk to your surgeon about what to expect.
Changes to Normal Activities: Daily activities will require more preparation, more time, and more energy. You will likely need more rest and will need to be attentive to good health and nutrition.
Clothing Adaptations: Think about loose clothing options that will fit over the fixator. Consider swimwear that ties at the side, or modifying some underwear to tie on one side.
Insurance Coverage: Know your insurance plan and make sure to secure all approvals prior to surgery. Find out what your insurance will cover for medical equipment as you will need several medical items during your external fixator treatment time. Your surgeon's clinic can give you a list of items that you may need to give to your insurance company.
- Ilizarova, GA, "The Tension-Stress Effect on the Genesis and
Growth of Tissues: Part II. The Influence of the Rate and Frequency of Distraction.", Clinical Orthopaedics & Related Research. 239:263-285, February 1989
- Rampurada A, Madan S, Tadross T. "Treatment of complex tibial plateau and distal tibial fractures with Taylor Spatial Frame: experience in a district general hospital.", Eur J Orthop Surg Traumatol. 2008;18:521-524.
- Ashfaq K, Fragomen AT, Nguyen TJ, Rozbruch SR. "Correction of Proximal Tiba Varus with External Fixation.", J Knee Surg. 2012;25:375-384.
- Elbatrawy Y, Fayed M. "Deformity Correction With an External Fixator : Ease of Use and Accuracy?", Orthopedics. 2009;32(2):82.
- Sala F, Thabet AM, Castelli F, et al. "Bone Transport for Postinfectious Segmental Tibial Bone Defects With a Combined Ilizarov/Taylor Spatial Frame Technique.", J Orthop Trauma. 2011;25:162-168.