Strategies in Trauma and Limb Reconstruction

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VOLUME 19 , ISSUE 1 ( January-April, 2024 ) > List of Articles


The Use of the Taylor Spatial Frame in Treating Tibial Osteomyelitis Following Traumatic Tibial Fracture

Rahul Geetala, James Zhang, Daniel Maghsoudi, Amindu Madigasekara, Matija Krkovic

Keywords : Distraction osteogenesis, Ilizarov technique, Osteomyelitis, Taylor spatial frame

Citation Information : Geetala R, Zhang J, Maghsoudi D, Madigasekara A, Krkovic M. The Use of the Taylor Spatial Frame in Treating Tibial Osteomyelitis Following Traumatic Tibial Fracture. 2024; 19 (1):32-35.

DOI: 10.5005/jp-journals-10080-1613

License: CC BY-NC 4.0

Published Online: 06-05-2024

Copyright Statement:  Copyright © 2024; The Author(s).


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.

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