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72:. Each strut can be independently lengthened or shortened to achieve the desired result, e.g. compression at the fracture site, lengthening, etc. Connected to a bone by tensioned wires or half pins, the attached bone can be manipulated in three dimensions and 9 degrees of freedom. Angular, translational, rotational, and length deformities can all be corrected simultaneously with the TSF.
112:, and length deformity values are then entered into specialised software, along with mounting parameters and hardware parameters such as the ring size and initial strut lengths. The software then produces a "prescription" of strut changes that the patient follows. The struts are adjusted daily by the patient until the correct alignment is achieved.
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When the bone has sufficiently healed, the frame can be dynamised. This is a process of gradually reducing the supportive role of the frame by reducing the length stability. This causes force that was previously transmitted around the fracture site and through the struts to be transmitted through the
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Cases involving treatment of nonunion of fracture are complicated and time-consuming with costs of around 30,000 pounds sterling in 2006 and treatment can take between 1 and 2 years. Of these costs about 23,000 pound sterling reflect follow-up outpatient treatment and cost for hospital stays, which
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Correction of the bone deformity can typically take 3–4 weeks. For simpler fractures where no deformity is present the struts may still be adjusted post-surgery to achieve better bone alignment, but the correction takes less time. For individuals performing strut adjustment. a hand mirror may be
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take longer to heal, and infection will delay union. For tibial fractures union is generally achieved after between 3 and 6 months, though time to union can be rather subjective, and the dynamistion process combined with irregular appointments may interfere with these measures.
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solution (advice varies from every day to every week), regular showering, and dressing of sites that exude liquid with non-woven gauze soaked in chlorhexidine gluconate. This dressing can be held in place with bungs or makeshift clips or by twisting around the wire.
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Advice varies as to whether scab tissue or any "crust" surrounding a pin site should be maintained. With some literature arguing that this acts as a barrier to entry, while other literature argues this may increase the risk of infection.
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Infection of the pin sites (points where wires enter the skin) of the TSF is a common complication (estimates are that it affects 20% percent of patients). In extreme cases this can result in
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deformities. It can be used on both the upper and lower limbs. Specialised foot rings (which are not seen in the picture) are also available for the treatment of complex foot deformities.
361:"Open reduction and internal fixation compared with circular fixator application for bicondylar tibial plateau fractures. Results of a multicenter, prospective, randomized clinical trial"
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Once the deformity has been corrected, the frame is then left on the limb until the bone fully heals. This often takes 3–6 months, depending on the nature and degree of deformity.
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401:
618:, Ed Austin; Anthony James & James E. Orsak, "Orthopaedic spatial frame apparatus", published 2000-10-10, assigned to Smith and Nephew Inc
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The wires are then removed by first sterilising them and then pulling them through the leg using pliers. The threaded half pins are simply unscrewed.
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The cost of a frame itself was around 2,500 pounds sterling in 2006, though this cost will vary depending on the number of components in the frame.
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Best practice for maintenance of pin sites is unclear and requires more study. Common practice involves the regular cleaning of the pin sites with
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The taylor spatial frame is a general tool for fixating and moving bone fragments in a gradual way. This means that costs can vary dramatically.
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which is difficult to treat. However, pin site infections are normally successfully treated with a combination of oral antibiotics,
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360:
332:
Eidelman, M; Katzman, A. (October 2008). "Treatment of complex tibial fractures in children with the taylor spatial frame".
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After a period of dynamisation, the frame can be removed. This is a relatively simple procedure often performed under
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417:"Cost implications of the physiotherapy management of complex tibial fractures treated with circular frames"
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553:"Management of complex tibial and femoral nonunion using the Ilizarov technique, and its cost implications"
469:"Management of complex tibial and femoral nonunion using the Ilizarov technique, and its cost implications"
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615:
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Once the fixator is attached to the bone, the deformity is characterised by studying the postoperative
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359:
Department of
Surgery, St. Michael's Hospital and the University of Toronto, ON, Canada. (Dec 2006).
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and therefore has lower risks of infection associated with it. This is particularly relevant for
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60:, and was invented by orthopaedic surgeon Charles Taylor. The device consists of two or more
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The time taken for bones to heal (time to union) varies depending on a number of factors.
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Information on Taylor
Spatial Frame (TSF), design, geometry, advantages and limitations
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The TSF is used in both adults and children. It is used for the treatment of acute
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A Taylor
Spatial Frame on the left leg consisting of metal rings, pins and struts
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the use of circular frames (like TSF) has markedly reduced infection rates.
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Choudhuri, Milind (2008). "Taylor
Spatial Frame". In Kulkarni, G.S. (ed.).
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48:. The medical device shares a number of components and features of the
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Site with crust and no exudate: some advice suggests maintaining crust
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The rings are removed by cutting the olive wires using wire cutters.
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Site with a lot of dried exudate that might merit dressing
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External fixation via TSFs tends to be less invasive than
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Site with "weeping" exudate that might merit dressing
415:Barron E, Rambani R, Bailey H, Sharma HK (2013).
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244:antibiotics, or removal of the affected pin.
116:useful to aid in reading the strut settings.
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600:(2nd ed.). Jaypee Brothers Publishers.
536:: CS1 maint: multiple names: authors list (
400:: CS1 maint: multiple names: authors list (
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508:Timms, Vincent, Santy-Tomlinson, Hertz.
278:can vary dramatically between patients.
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598:Textbook of orthopedics and trauma
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52:. The Taylor Spatial Frame is a
421:Strategies Trauma Limb Reconstr
658:Orthopedic surgical procedures
551:Patil S, Montgomery R (2006).
467:Patil S, Montgomery R (2006).
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79:, mal-unions, non-unions and
570:10.1302/0301-620X.88B7.17639
486:10.1302/0301-620X.88B7.17639
247:Pin sites are classified as
510:"Guidance on pin site care"
230:Pin sites in various states
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433:10.1007/s11751-013-0173-8
517:Royal College of Nursing
313:Octopod External Fixator
288:Distraction osteogenesis
87:Post Operative procedure
663:Orthopaedic instruments
256:chlorhexidine gluconate
68:rings connected by six
616:US Active 6129727A
92:Correcting deformities
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557:J Bone Joint Surg Br
473:J Bone Joint Surg Br
380:10.2106/JBJS.E.01416
368:J Bone Joint Surg Am
38:orthopaedic surgeons
26:Taylor Spatial Frame
641:2016-04-06 at the
56:device based on a
50:Ilizarov apparatus
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308:External fixation
267:Cost of treatment
169:fractures of the
156:internal fixation
150:Use for fractures
42:complex fractures
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28:(TSF) is an
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522:15 November
334:Orthopedics
242:intravenous
140:analgesic.
138:gas and air
652:Categories
319:References
167:comminuted
110:rotational
81:congenital
185:Infection
165:For open
77:fractures
40:to treat
34:podiatric
639:Archived
579:16798998
532:cite web
495:16798998
451:23943063
388:17142411
346:19226013
282:See also
102:CT scans
62:aluminum
32:used by
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251:wounds
54:hexapod
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340:(10).
128:bone.
98:x-rays
70:struts
513:(PDF)
364:(PDF)
100:, or
602:ISBN
575:PMID
538:link
524:2015
491:PMID
447:PMID
402:link
384:PMID
342:PMID
44:and
36:and
24:The
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481:doi
437:PMC
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
