Correction of Tibial Deformity with Use of the Ilizarov-Taylor Spatial Frame

• DOI: 10.2106/jbjs.f.00745
• Publication Date: 2006-12-01T18:13:10Z
• Authors: S. Robert Rozbruch; Austin T. Fragomen; Svetlana Ilizarov
• Keywords: Postoperative Care; 03 medical and health sciences; 0302 clinical medicine; External Fixators; Tibia; Humans; Ilizarov Technique; Osteotomy

The Ilizarov-Taylor Spatial Frame (TSF; Smith and Nephew, Memphis, Tennessee) is a powerful tool for correcting tibial deformity1-6. A specialized feature of the TSF is its virtual hinge, which allows for the simultaneous gradual correction of multiplanar deformities and limb-lengthening through one osteotomy site. The power of the spatial frame lies in its precise control over the final limb length and alignment and in its ability to correct a residual deformity. The stability of this multiplanar circular fixator permits early weight-bearing and provides an ideal environment for both new-bone formation and soft-tissue healing. The classic principles of the Ilizarov method are followed to ensure proper frame application. The TSF web-based software is user-friendly and has greatly simplified the planning of the correction of an oblique plane deformity by utilizing standard anterior-posterior and lateral radiographic measurements. Computer-generated schedules and easy-to-read struts have greatly simplified patient involvement, which is crucial to the success of this technique. ### Preoperative Planning Patients are evaluated clinically by a history and physical examination including observation of gait. Special attention is directed toward the assessment of leg length, mechanical axis deviation, and rotational alignment (Fig. 1). An erect bipedal 51-in (130-cm) radiograph in the frontal plane is made. If there is a leg-length discrepancy, then blocks are placed under the affected foot to level the pelvis, and the block height is recorded. Accurate limb lengths are measured in this way. Sagittal deformity about the knee is evaluated with a 36-in (91-cm) lateral radiograph made with the knee in full extension. Routine anteroposterior and lateral radiographs of the tibia are made as well. Ankle deformity should be evaluated with the x-ray beam centered on the ankle. Mechanical axis deviation is determined with use of the malalignment test7,8 (Fig. 2). The lateral distal femoral angle, …