Intentional Deformation and Closure of Soft Tissue Defect in Open Tibial Fractures With a Taylor Spatial FrameA Simple Technique

Objectives: We describe a way of using Taylor spatial frames (TSFs) for acute deformation of Gustilo IIIB tibial fractures and infected tibial nonunions to close the soft tissue defects and to gradually restore anatomical alignment. We use the Direct Scheduler Utility module of the web-based software for TSFs to successfully restore the anatomical alignment.Design: We report a case series of the above technique.Setting: Care was carried out at a tertiary referral center for limb reconstruction.Patients: Seven consecutive patients with significant soft tissue loss after tibial fractures were treated.Intervention: Defects were closed with acute deformation of the fracture followed by gradual correction to anatomical alignment with a 2-ring TSF.Main Outcome Measurement: Successful closure of the soft tissue defect was our primary outcome measure.Results: Soft tissue defects ranged from 3 to 10 cm. All healed without additional plastic surgery to cover the exposed tibia. Only 1 patient required an additional TSF prescription to achieve anatomical alignment.Conclusions: The use of the Direct Scheduler module of the web-based TSF software allows the complete correction of complex deformities without the need for obtaining complex mounting and frame parameters. We achieved successful closure of soft tissue defects and restored the anatomical tibial alignment in all our cases.