MECHANICAL CHARACTERISATIONS OF THE TAYLOR SPATIAL FRAME IN LIMB RECONSTRUCTION SURGERY AND THEIR CLINICAL IMPLICATIONS

Abstract

The Taylor Spatial Frame (TSF) is a new circular external fixator associated with a web based computer program representing a more developed version of the Ilizarov device and is characterised by its ease in application and function. It allows accurate correction of limb deformities and precise lengthening but its mechanical characteristics have not been fully investigated. In introduction, I present my clinical work in paediatric limb reconstruction by reviewing papers published as a sole author or co-author in peer review journals prior to this thesis. In the chapters to follow I present and investigate by performing mechanical tests six clinical problems/issues/concerns encountered in my clinical practice. These are wire slippage, ineffective wire clamping mechanism, catastrophic ring failure, anterior tibial angulation during lengthening, restricted knee motion and posterior knee impingement and strut obliquity. Wire slippage is related to the effectiveness of the clamping mechanism which can be improved by increasing the pressure exerted by the bolt on the wire and using the appropriate level of torque in order to tighten the wire on the ring. Castastrophic ring failure is related to the use of large jointed rings. Anterior angulation during tibial lengthening is related to the placement of anterior pins; the use of more divergent pins is therefore recommended. Accepting that a proximal two third ring can also be used, I introduced the idea of a modular frame which during the last part of the treatment would allow removal of its posterior knee elements allowing better knee mobilisation. The use of long, obliquely situated struts attached on large rings can lead to frame instability and should be avoided. Recommendations are made to the operating surgeon and medical companies in order to improve performance.

Date of Award	20 Feb 2018
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Sunday Oyadiji (Main Supervisor)