Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 May;8(3):273-9.
doi: 10.1007/s11832-014-0583-2. Epub 2014 Apr 19.

Management of paediatric tibial fractures using two types of circular external fixator: Taylor spatial frame and Ilizarov circular fixator

Suhayl Tafazal  1 , Sanjeev S Madan, Farhan Ali, Manoj Padman, Simone Swift, Stanley Jones, James A Fernandes
Affiliations

Management of paediatric tibial fractures using two types of circular external fixator: Taylor spatial frame and Ilizarov circular fixator

Suhayl Tafazal et al. J Child Orthop. 2014 May.

Abstract

Background: The use of circular fixators for the treatment of tibial fractures is well established in the literature. The aim of this study was to compare the Ilizarov circular fixator (ICF) with the Taylor spatial frame (TSF) in terms of treatment results in consecutive patients with tibial fractures that required operative management.

Method: A retrospective analysis of patient records and radiographs was performed to obtain patient data, information on injury sustained, the operative technique used, time duration in frame, healing time and complications of treatment. The minimum follow-up was 24 months.

Results: Ten patients were treated with ICF between 2000 and 2005, while 15 patients have been treated with TSF since 2005. Two of the 10 treated with ICF and 5 of the 15 treated with TSF were open fractures. All patients went on to achieve complete union. Mean duration in the frame was 12.7 weeks for ICF and 14.8 weeks for the TSF group. Two patients in the TSF group had delayed union and required additional procedures including adjustment of fixator and bone grafting. There was one malunion in the TSF group that required osteotomy and reapplication of frame. There were seven and nine pin-site infections in the ICF and TSF groups, respectively, all of which responded to antibiotics. There were no refractures in either group.

Conclusion: In an appropriate patient, both types of circular fixator are equally effective but have different characteristics, with TSF allowing for postoperative deformity correction. Of concern are the two cases of delayed union in the TSF group, all in patients with high-energy injuries. We feel another larger study is required to provide further clarity in this matter.

Level of evidence: Level II-comparative study.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Preoperative radiograph of a segmental tibial fracture
Fig. 2
Fig. 2
Taken during treatment once the Ilizarov frame had been attached
Fig. 3
Fig. 3
Showing sound union at the level of the original fracture
Fig. 4
Fig. 4
Preoperative radiograph of an unstable proximal 1/3 tibial fracture
Fig. 5
Fig. 5
Immediate postoperative radiograph following stabilisation with TSF
Fig. 6
Fig. 6
Following correction of the residual deformity with the TSF programme
See this image and copyright information in PMC

References

    1. Briggs TW, Orr MM, Lightowler CD. Isolated tibial fractures in children. Injury. 1992;23(5):308–310. doi: 10.1016/0020-1383(92)90175-R. - DOI - PubMed
    1. Kubiak EN, Egol KA, Scher D, Wasserman B, Feldman D, Koval KJ. Operative treatment of tibial fractures in children: are elastic stable intramedullary nails an improvement over external fixation? J Bone Jt Surg Am. 2005;87(8):1761–1768. doi: 10.2106/JBJS.C.01616. - DOI - PubMed
    1. Swindells MG, Rajan RA (2010) Elastic intramedullary nailing in unstable fractures of the paediatric tibial diaphysis: a systematic review. J Child Orthop 4(1):45–51 - PMC - PubMed
    1. El-Adl G, Mostafa MF, Khalil MA, Enan A. Titanium elastic nail fixation for paediatric femoral and tibial fractures. Acta Orthop Belg. 2009;75(4):512–520. - PubMed
    1. Gordon JE, Gregush RV, Schoenecker PL, Dobbs MB, Luhmann SJ. Complications after titanium elastic nailing of pediatric tibial fractures. J Pediatr Orthop. 2007;27(4):442–446. doi: 10.1097/01.bpb.0000271333.66019.5c. - DOI - PubMed