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VOLUME 18 , ISSUE 2 ( May-August, 2023 ) > List of Articles

ORIGINAL RESEARCH

Bone Transport with the Taylor Spatial Frame Technique: A Case Series

Kanu Shimokawa, Hidenori Matsubara, Toshifumi Hikichi, Hiroyuki Tsuchiya

Keywords : Bone transport, Bone tumour, Non-union, Plate conversion, Taylor Spatial Frame

Citation Information : Shimokawa K, Matsubara H, Hikichi T, Tsuchiya H. Bone Transport with the Taylor Spatial Frame Technique: A Case Series. 2023; 18 (2):117-122.

DOI: 10.5005/jp-journals-10080-1594

License: CC BY-NC-SA 4.0

Published Online: 26-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

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.

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  1. Tsuchiya H, Tomita K, Minematsu K, et al. Limb salvage using distraction osteogenesis. A classification of the technique. J. Bone Joint Surg Br 1997;79(3):403–411. DOI: 10.1302/0301-620x.79b3.7198.
  2. Kabata T, Tsuchiya H, Sakurakichi K, et al. Reconstruction with distraction osteogenesis for juxta-articular nonunions with bone loss. J Trauma 2005;58(6):1213–1222. DOI: 10.1097/01.ta.0000169806.08994.e2.
  3. Cierny G III, Zorn KE. Segmental tibial defect. Comparing conventional and Ilizarov methodologies. Clin Orthop Relat Res 1994;301:118–123. PMID: 8156662.
  4. Lavini F, Dall’Oca C, Bartolozzi P. Bone transport and compression-distraction in the treatment of bone loss of the lower limbs. Injury 2010;41(11):1191–1195. DOI: 10.1016/j.injury.2010.09.030.
  5. Cattaneo R, Catagni M, Johnson EE. The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov. Clin Orthop Relat Res 1992;280:143–152. PMID: 1611734.
  6. Paley D. Frontal plane mechanical plane and anatomic axis planning. In: Paley D, editor. Principle of Deformity Correction. Berlin: Springer–Verlag; 2005, pp. 61–76.
  7. Paley D, Catagni MA, Argnani F, et al. Ilizarov treatment of tibial nonunions with bone loss. Clin Orthop Relat Res 1989;241:146–165. PMID: 2924458.
  8. Enneking WF, Eady JL, Burchardt H. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 1980;62(7):1039–1058. PMID: 7000788.
  9. Shapiro MS, Endrizzi DP, Cannon RM, et al. Treatment of tibial defects and nonunions using ipsilateral vascularized fibular transposition. Clin Orthop Relat Res 1993;296:207–212. PMID: 8222427.
  10. Date AS, Solanki SB, Badhe NP, et al. Management of gap non-union of tibia by tibialisation of ipsilateral vascular fibula. J Postgrad Med 1996;42(4):109–111. PMID: 9715311.
  11. Shafi R, Fragomen AT, Rozbruch SR. Ipsilateral fibular transport using Ilizarov–Taylor spatial frame for a limb salvage reconstruction: A case report. HSS J 2009;5(1):31–39. DOI: 10.1007/s11420-008-9102-7.
  12. Mankin HJ, Hornicek FJ, Raskin KA. Infection in massive bone allografts. Clin Orthop Relat Res 2005;432:210–216. DOI: 10.1097/01.blo.0000150371.77314.52.
  13. Wood MB. Free vascularized fibular grafting—25 years’ experience: Tips, techniques and pearls. Orthop Clin North Am 2007;38(1):1–12. DOI: 10.1016/j.ocl.2006.10.007.
  14. Mozzafarian K, Lascombes P, Dautel G. Vascular basis of free transfer of proximal epiphysis and diaphysis of fibula: An anatomical study. Arch Orthop Trauma Surg 2009;129(2):183–187. DOI: 10.1007/s00402-008-0600-3.
  15. Taylor BC, French BG, Fowler TT, et al. Induced membrane technique for reconstruction to manage bone loss. J Am Acad Orthop Surg 2012;20(3):142–150. DOI: 10.5435/JAAOS-20-03-142.
  16. Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet 2000;45(3):346–353. PMID: 10929461.
  17. Ren C, Li M, Ma T, et al. A meta-analysis of the Masquelet technique and the Ilizarov bone transport method for the treatment of infected bone defects in the lower extremities. J Orthop Surg (Hong Kong) 2022;30(2):10225536221102685. DOI: 10.1177/10225536221102685.
  18. Al-Sayyad MJ. Taylor spatial frame in the treatment of upper extremity conditions. J Pediatr Orthop 2012;32(2):169–178. DOI: 10.1097/BPO.0b013e3182471ae4.
  19. 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(3):162–168. DOI: 10.1097/BOT.0b013e3181e5e160.
  20. Abuomira IE, Sala E, Elbatrawy Y, et al. Distraction osteogenesis for tibial nonunion with bone loss using combined Ilizarov and Taylor spatial frames versus a conventional circular frame. Strategies Trauma Limb Reconstr 2016;11(3):153–159. DOI: 10.1007/s11751-016-0264-4.
  21. Robert RS, Weitzman AM, Tracey WJ, et al. Simultaneous treatment of tibial bone and soft-tissue defects with the Ilizarov method. J Orthop Trauma 2006;20(3):197–205. DOI: 10.1097/00005131-200603000-00006.
  22. Seybold D, Gessmann J, Ozokyay L, et al. The Taylor spatial frame. Correction of posttraumatic deformities of the tibia and hindfoot. Unfallchirurg 2008;111(12):985–986, 988–995. DOI: 10.1007/s00113-008-1488-7.
  23. Paley D, Maar DC. Ilizarov bone transport treatment for tibial defects. J Orthop Trauma 2000;14(2):76–85. DOI: 10.1097/00005131-200002000-00002.
  24. Mizoshiri N, Shirai T, Terauchi R, et al. Limb saving surgery for Ewing's sarcoma of the distal tibia: A case report. BMC Cancer 2018;18(1):503. DOI: 10.1186/s12885-018-4372-z.
  25. Rozbruch SR, Pugsley JS, Fragomen T, et al. Repair of tibial nonunions and bone defects with the Taylor spatial frame. J Orthop Trauma 2008;22(2):88–95. DOI: 10.1097/BOT.0b013e318162ab49.
  26. Feldman DS, Shin SS, Madan S, et al. Correction of tibial malunion and nonunion with six-axis analysis deformity correction using the Taylor spatial frame. J Orthop Trauma 2003;17(8):549–554. DOI: 10.1097/00005131-200309000-00002.
  27. Dendrinos GK, Kontos S, Lyritsis E. Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg Br 1995;77(6):835–846. DOI: 10.2106/00004623-199506000-00004.
  28. Cimbrelo EG, Gonzales JCM. Circular external fixation in tibial nonunion. Clin Orthop Relat Res 2004;419:65–70. PMID: 15021133.
  29. Giotakis N, Narayan B, Nayagam S. Distraction osteogenesis and nonunion of the docking site: is there an ideal treatment option? Injury 2007;38(Suppl. 1):100–107. DOI: 10.1016/j.injury.2007.02.015.
  30. Lovisetti G, Sala F, Miller AN, et al. Clinical reliability of closed techniques and comparison with open strategies to achieve union at the docking site. Int Orthop 2012;36(4):817–825. DOI: 10.1007/s00264-011-1260-4.
  31. Watanabe K, Tsuchiya H, Yamamoto N, et al. Over 10-year follow-up of functional outcome in patients with bone tumours reconstructed using distraction osteogenesis. J Orthop Sci 2013;18(1):101–109. DOI: 10.1007/s00776-012-0327-4.
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