Die Korrektur von posttraumatischen Fehlstellungspseudarthrosen der Tibia mit dem Taylor Spatial Frame

Abstract

Correction of severe tibial deformity due to a non-union of the tibia is best achieved by a slow gradual correction which allows the compromised tissue to adapt. The Taylor spatial frame (TSF) is a hexapod-based ring fixator that allows a simultaneous gradual correction of a multiplanar deformity through a virtual hinge. The aim of this study was to demonstrate the application of the TSF and the clinical outcomes of ten patients with a non-union of the tibia. Ten patients with either a hypertrophic or atrophic non-union of the tibia were treated between 2003 and 2006 with the TSF. The mean age of these patients was 43 years (range: 12-73). There were 5 hypertrophic and 5 atrophic non-unions. Five of the ten fractures were initially open. The mean preoperative magnitude of the angulation deformity was 21.9 degrees (range: 5-44). In nine patients, the correction was performed in a closed manner; one patient had hardware removed prior to the frame application. In all ten patients, the deformities were corrected. The average duration of time that the frame was worn was 158.5 days (range: 89-300). The mean time for gradual correction was 23.1 days (range: 5-43) with an average correction speed of 1.3 mm/day (range: 0.5-2). No additional bone stimulation was performed. In terms of complications, one patient had a residual valgus deformity of 5 degrees , one a pin tract infection, and one a stress fracture next to a pin hole. In patients with either a hypertrophic or oligotrophic non-union of the tibia and severe deformity, the TSF is a powerful tool to correct the deformity in a closed manner which preserves the remaining viability of the non-union.