Functional outcome of Taylor Spatial Frame for treatment of proximal tibial nonunion with medial compartment arthritis | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 47, Issue 4, December 2012, Page 380-385 PDF (203.92 K) | ||||
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| Author | ||||
| Mohammed J. Al-Sayyad | ||||
| Abstract | ||||
| Background The management of proximal tibial nonunion has proven to be more difficult than that of diaphyseal tibial nonunion. The Taylor Spatial Frame (TSF) is an evolution of the original Ilizarov circular frame as it uses a virtual hinge and a computer program to simultaneously correct all aspects of deformities. The aim of this study was to assess the functional and radiographic outcome of the TSF with valgus overcorrection in patients with proximal tibial nonunion and medial compartment arthritis. Materials and methods Nine patients with proximal tibial atrophic nonunion were identified from our prospective functional TSF database. They included five men and four women with an average age of 64 years. The mean follow-up was 4 years. Patient charts were retrospectively reviewed for demographic data, mechanism of injury, comorbidities, surgical data, complications, and functional outcome. Radiographic films from studies which included radiographs for both lower limbs were reviewed for alignment and arthritic changes. Patients were treated using the TSF and by bone grafting with gradual valgus overcorrection. Results Bony union was the final result in all nine patients. Angular deformities included genu varum with an average angle of 25°, which was gradually corrected to genu valgus with an average angle of 6° in all patients. The SF-36 health status survey improved in all eight categories. Marked improvement was noted in two categories: physical function improved from a mean of 26.66 to 65 (t-value of 36.36, <0.001) and general health status improved from a mean of 26.66 to 75 (t-value of 17.33, <0.001) in the paired -test. Conclusion Using the TSF to correct malalignment in both frontal and sagittal planes and overcorrecting it into a valgus position, in addition to offering compression at the grafted nonunion site, led to healing of the nonunion and significant improvement in the functional outcome in this group of patients, as demonstrated by the SF-36 health status survey and the excellent radiographic results. | ||||
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