Francesco Sala1, Ahmed M Thabet, Paolo Capitani, Federico Bove, Amr A Abdelgawad, Giovanni Lovisetti. 1. *Department of Orthopedic Surgery and Traumatology, Niguarda Hospital, Milan, Italy; †Department of Orthopaedic Surgery and Rehabilitation, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX; and ‡Department of Orthopedic Surgery and Traumatology, Menaggio Hospital, Como, Italy.
Abstract
OBJECTIVES: To evaluate the Taylor spatial frame (TSF) for primary and definitive fixation of open supracondylar-intracondylar femoral (SIF) fractures. DESIGN: Retrospective. SETTING: Level I trauma center. PATIENTS: Subset of 20 SIF open fractures treated with TSF extracted from a consecutive series of 80 SIF fractures treated between 2007 and 2013. INTERVENTION: Eighteen (90%) fractures underwent definitive fixation with the TSF; 2 were treated primarily within 24 hours of injury. Mean time interval between primary treatment and secondary TSF was 5 days. MAIN OUTCOME MEASUREMENTS: Clinical and radiological. RESULTS: Complete union was obtained in 17 (85%) fractures without additional surgery at an average of 33 weeks. Three nonunions and 1 malunion occurred. No deep infection occurred. Results based on Association for the Study and Application of the Method of Ilizarov criteria: 37% excellent, and 63% good for bone outcomes; 5% excellent, 58% good, and 37% fair for functional outcomes. Neer knee scores were 21% excellent, 68% good, and 11% fair. The mechanical lateral distal femoral angle and anatomic posterior distal femoral angle values were within normal range in 80% and 90% of patients, respectively. Abnormal mechanical axis deviation was observed in 4 (20%) cases (2 had associated tibia fractures). CONCLUSIONS: Primary and definitive fixation with the TSF are effective. Advantages include continuity of device until union, reduced risk of infection, early mobilization, restoration of primary defect caused by bone loss, easy and accurate application, convertibility and versatility, and improved union rate and range of motion for SIF open fractures. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
OBJECTIVES: To evaluate the Taylor spatial frame (TSF) for primary and definitive fixation of open supracondylar-intracondylar femoral (SIF) fractures. DESIGN: Retrospective. SETTING: Level I trauma center. PATIENTS: Subset of 20 SIF open fractures treated with TSF extracted from a consecutive series of 80 SIF fractures treated between 2007 and 2013. INTERVENTION: Eighteen (90%) fractures underwent definitive fixation with the TSF; 2 were treated primarily within 24 hours of injury. Mean time interval between primary treatment and secondary TSF was 5 days. MAIN OUTCOME MEASUREMENTS: Clinical and radiological. RESULTS: Complete union was obtained in 17 (85%) fractures without additional surgery at an average of 33 weeks. Three nonunions and 1 malunion occurred. No deep infection occurred. Results based on Association for the Study and Application of the Method of Ilizarov criteria: 37% excellent, and 63% good for bone outcomes; 5% excellent, 58% good, and 37% fair for functional outcomes. Neer knee scores were 21% excellent, 68% good, and 11% fair. The mechanical lateral distal femoral angle and anatomic posterior distal femoral angle values were within normal range in 80% and 90% of patients, respectively. Abnormal mechanical axis deviation was observed in 4 (20%) cases (2 had associated tibia fractures). CONCLUSIONS: Primary and definitive fixation with the TSF are effective. Advantages include continuity of device until union, reduced risk of infection, early mobilization, restoration of primary defect caused by bone loss, easy and accurate application, convertibility and versatility, and improved union rate and range of motion for SIF open fractures. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.