An Introduction to the Taylor Spatial Frame for Foot and Ankle Applications
Section snippets
History
The historical concept for how the TSF works can be attributed to the development of projective geometry, Chasles axis, and the technological advances of the Stewart platform. The field of projective geometry, as developed by Gerard Desarques, Blaise Pascal, and Phillipe de la Hire, laid the foundation for understanding the relationship between lines, planes, and points, which was later incorporated in several mathematical theories.3
The Mozzi-Chasles’ theorem states that “the most general rigid
Indications of TSF
The indications of the TSF for the foot and ankle are numerous but should be reserved for severe deformities that are not braceable. Some deformities are not amenable to acute correction secondary to patient’s current medical status, past surgical history, active infection, or poor skin quality. The TSF can be used for fracture reduction and stabilization. Primary ring position is not critical to the mounting of the external fixator. Reduction does not have to be performed during the operation
Principles of Deformity Correction
Ordering the appropriate radiographs is the first step in proper deformity evaluation. Standard radiographs that we order at our institution for evaluating foot and ankle deformities include full-length anterior–posterior (AP) and lateral standing radiographs, AP and lateral ankle to include tibia, long leg calcaneal axial, Saltzman view, and foot views (AP, lateral, oblique). It is important to assess the location of deformity, any mechanical axis deviation, misalignments, and/or
Contraindications
Some contraindications to using the TSF include lack of familiarity with deformity planning, inexperience with TSF fixator and/or software, patient noncompliance and/or psychiatric impairment, patient comorbidities prohibiting surgery or anesthesia, and lack of indication for external fixator.
Advantages
There are advantages and disadvantages with the use of external fixators. Likewise, there are reasons to choose the TSF instead of the Ilizarov and vice versa. The use of external fixation devices has the advantage over internal fixation in that it is generally less invasive. Percutaneous techniques used with this method of fixation offer reduced surgical morbidity because of less operative exposure. Extensive periosteal stripping, especially in cases of malunion and nonunion, can be avoided.
Disadvantages
In some practices and institutions, it is cost-prohibitive to use the TSF. The cost of circular external fixators significantly increases with the use of struts. Likewise, the prescription for deformity correction may necessitate additional strut changes, which also are an additional expense. One recommendation for reducing the number of strut changes is being able to assess your deformity and mounting parameters in the operating room. A prescription for correction can be generated at that time
Conclusion
The TSF is an advanced orthopaedic modality that permits accurate correction of severe foot and ankle deformities. As specialists in foot and ankle surgery, this new technology will add to our armamentarium in reconstructing difficult deformities. The utility of TSF frames, coupled with an increasing familiarity of deformity planning, will play a major role in limb preservation and salvage.
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Treatment Strategies and Frame Configurations in the Management of Foot and Ankle Deformities
2018, Clinics in Podiatric Medicine and SurgeryCitation Excerpt :First attempts to standardize the nomenclature and description of the hexapod frames for foot and ankle were attempted by Taylor.6,7 In an attempt to describe these quite elaborate constructs he brought some carpentry terms into the external fixation (miter or butt constructs) and even more colloquial frame names like Tennessee torpedo.5,11 Takata and colleagues12 presented foot hexapod assemblies classification based on the frame position relative to the foot, orientation of the axis of the hexapod, and direction of the struts attachment to the reference ring.
The Taylor Spatial Frame™ for Correction of Neglected Fracture Dislocation of the Ankle
2011, Journal of Foot and Ankle SurgeryCitation Excerpt :Because the fracture was still un-united, we opted to treat the patient with the TSF, which allows care of soft tissue while simultaneously allowing a gradual reduction of the deformity and avoiding the need for open reduction. With the TSF, reduction of the deformity does not need to be performed at the time of the surgery and can be done over a period of weeks, allowing slow stretching of soft tissues (2). The principles of Ilizarov have been used to treat soft tissue contractures and joint subluxation by gradual distraction and correction (19).
Half-pin Breakage in Multiplanar External Fixators Used for Pediatric Deformity Correction
2023, Journal of Pediatric OrthopaedicsModel-Free Based Nonsingular Fast Terminal Sliding Mode Control for Gough-Stewart Platform
2023, Chinese Control Conference, CCCTreatment of Severe Rigid Posttraumatic Equinus Deformity With Gradual Deformity Correction and Arthroscopic Ankle Arthrodesis
2021, Foot and Ankle International