PreviousTibial Osteotomy And Deformity Correction With The Ilizarov Taylor Spatial Frame (Visit this link)
AAOS Scientific Exhibit 2006 Tibial Osteotomy and Deformity Correction With the Ilizarov/Taylor Spatial Frame: Clinical Experience, Surgical Planning, Video Surgical Demonstration, and Computer Animation Scientific Exhibit Number: SE26 Location: McCormick Place Hall B Adult Reconstruction Knee S Robert Rozbruch, MD New York NY (a - Smith & Nephew Inc.) Austin Fragomen, MD New York NY (a - Smith & Nephew Inc.) Arkady Blyakher, OPA Brooklyn NY (n) Svetlana Ilizarova, MD New York NY (a - Smith & Nephew Inc.) -------------------------------------------------------------------------------- The Taylor Spatial Frame (TSF) is an evolution of the classic Ilizarov frame. In this exhibit, we will present our clinical experience with tibial osteotomy, surgical planning, the deformity correction software, a video surgical demonstration, and a computer animation. The Taylor Spatial Frame (TSF) is an evolution of the classic Ilizarov frame. It utilizes a computer program, which helps calculate a schedule for gradual strut and frame adjustment to simultaneously correct multiple aspects of deformity around a virtual hinge without the need for complicated frame modification. In this exhibit, we will present our clinical experience, surgical planning, the deformity correction software, a video surgical demonstration, and a computer animation. Forty-two patients (50 tibiae) underwent osteotomy surgery for deformity correction using the Taylor Spatial Frame between 2000 and 2003. Malunion was the most common etiology (23 limbs). Other causes included developmental deformity such as genu varum (19 limbs) or genu valgum (4 limbs) with pain and/or osteoarthritis, congenital deformity (2) and neurologic disorders (2). The osteotomy was performed near the apex of the deformity, which was at the proximal tibia in 33, middle tibia in 9 and distal tibia in 8. Varus angulation was the most common deformity. Mechanical axis deviation (MAD) and joint orientation angles were used to evaluate the deformity. Rotational deformity was assessed clinically. Twenty-five patients had leg length discrepancy with 3.1cm average (range: 0.4 -22 cm). Tibia and fibula osteotomies were performed for deformity correction. Double level osteotomy was performed on one tibia. Planned deformity correction in different planes was achieved in all cases using TSF The average medial MAD improved from 28 mm to 4 mm medial or to 7 mm lateral in cases with hypercorrection. The average lateral MAD improved from 42 mm to 0 and in cases of osteoarthritis was overcorrected to 9 mm medial to midline to unload affected compartment of the knee. Simultaneous lengthening of 2.1 cm was done in 14 patients (16 limbs). Average time in a frame was 131 days and there were no nonunions. Osteotomy of the tibia and fibula and the use of the Ilizarov/ Taylor Spatial Frame can be used effectively to correct leg deformities. All aspects of deformity are addressed including length. This technique uses a minimally invasive approach and gradual deformity correction.
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Added: Tue May 09 2006
