gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie, 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

25. - 28.10.2011, Berlin

Deformity correction with the Taylor Spatial Frame after growth arrest of the distal radius

Meeting Abstract

Suche in Medline nach

  • D. Seybold - BG-Universitätsklinikum Bergmannsheil, Chirurgische Klinik und Poliklinik, Bochum, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 25.-28.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocPO12-1623

DOI: 10.3205/11dkou564, URN: urn:nbn:de:0183-11dkou5649

Veröffentlicht: 18. Oktober 2011

© 2011 Seybold.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Questionnaire: The Taylor Spatial Frame (TSF) is a hexapod based external ring fixator, which is widely used to perform six-axis deformity corrections of the lower limb. TSF-planning is web based (www.spatialframe.com) but its use is only available for lower extremities. The purpose of this study was to apply the TSF to the upper extremities to correct pseudo-Madelung deformities.

Methods: Defining the nomenclature - To correct bony deformities with the TSF, one must determine the deformity parameters, the frame parameters, and mounting parameters for the web based planning program. The six deformity parameters and the four mounting parameters use the anatomic nomenclature for the lower extremities. To use the TSF on the forearm, one must transfer the nomenclature of the deformity parameters and the mounting parameters to the nomenclature of the forearm With the transferred nomenclature, one can correct forearm deformities with the correction mode Long Bone of the planning program for the lower limb.

Patients - Two boys (Patient 1, 13 years, Patient 2, 14 years old) and two girls (Patient 3, 8 years, Patient 4, 7 years) were seen in our clinic with progressive pseudo-Madelung deformities after an epiphysial fracture of the distal radius at age 12 in the boys and 6 in the girls. Skeletal maturity (RUS, TW3 method) was equivalent to the patient's age.

Results and Conclusions: In the two patients, the multiplanar deformitiy of the distal radius could be corrected anatomically with the TSF. There were no frame changes or frame modifications necessary for deformity correction. Patient 2 was slightly overcorrected because of some growth in the distal ulnar growth plate. During the distraction, each patient had two low-dose CT scans for better visualization of the radiocarpal and radioulnar joint. The web-based planning program was adjusted twice until total deformity correction was achieved. No further immobilization after frame removal was required. The one-year follow-up showed an anatomic aligned forearm/hand relation with increased pronation and supination compared to the preoperative range of motion in all patients. The wrist and especially the DRUJ were stable and reduced at the one-year follow-up examination. The patients did not complain about any pain or functional deficits in the hand.

In conclusion, the power of the TSF with the ability to move two fragments precisely can be transferred to the forearm. This allows for the correction of multiplanar radial deformities simultaneously without the need for frame modifications of rotational and translational deformities, as is necessary with the standard Ilizarov system.