Table of Contents
System Overview
Constructing a Stable Frame
Techniques in Trauma
Techniques in Deformity Correction
Video Library

System Overview

SMART TSF◇ is a Ring-based External Fixator used in the management of fractures and correction of long bone deformities.

The TSF construct consists of two Rings and six telescoping Struts in the specific configuration described in “TSF Assembly.”

The TSF is applied to bone according to Ilizarov principles.1,2

HA-Coated Half Pins of 4.5mm or 6mm diameter and Wires of 1.5mm or 1.8mm diameter connect the Rings to the bone.

system overview

Once TSF◇ has been surgically applied, the parameters of the deformity and the details of the hardware can be entered in the web-based application SMART-TSF.com. The program will generate a prescription of Strut adjustments that reduce the angulations, rotations and translations to zero. The patient performs the Strut adjustments at a rate and rhythm determined by the surgeon. The Strut adjustments cause movement of one Ring relative to the other. The Strut adjustment schedule may last a number of weeks, thereafter, the patient enters the consolidation phase of bone healing.

The TSF system offers the following—

  • Early and progressive weight-bearing when appropriate3,4
  • Fixation in good bone with soft tissue coverage, staying away from the compromised zone of injury
  • Anatomic reduction and alignment can be refined post-operatively2
  • No hardware left behind after treatment
  • Restoration of the mechanical axis of the limb5

SMART TSF components are compatible with all existing TAYLOR SPATIAL FRAME◇ Hardware. SMART TSF Software supports constructs assembled using classic TAYLOR SPATIAL FRAME Hardware. A complete list of components is detailed in the ILIZAROVTM and TAYLOR SPATIAL FRAME Pocket Guide.

Smith & Nephew’s External Fixation Systems may be used for patients fitting the indications and that do not present any of the contraindications. The subject system is intended to be used for children and adults of all ages. The general principles of good patient selection and sound surgical judgement apply to external fixation procedures. Preoperative planning and meticulous surgical technique are essential to achieve optimum results. Considerations of anatomical loading, soft-tissue condition, and component placement are critical to minimize a variety of complications. An individualized configuration should be designed for each case to suit the specific application.

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References

  1. The Original Ilizarov System General Surgical Technique Brochure; MedicalPlastic 1998.
  2. Ilizarov GA. The Tension-Stress Effect on the Genesis and Growth of Tissues; USSR Academy of Sciences and the Kurgan All-Union Center for Restorative Traumatology and Orthopaedics, Kurgan, 1998.
  3. Rampurada A, Madan S, Tadross T. Treatment of complex tibial plateau and distal tibial fractures with Taylor Spatial Frame: experience in a district general hospital. Eur J Orthop Surg Traumatol. 2008;18:521-524.
  4. Ashfaq K, Fragomen AT, Nguyen TJ, Rozbruch SR. Correction of Proximal Tibia Varus with External Fixation. J Knee Surg. 2012;25:375-384.
  5. Elbatrawy Y, Fayed M. Deformity Correction With an External Fixator : Ease of Use and Accuracy? Orthopedics. 2009;32(2):82.
  6. Sala F, Thabet AM, Castelli F, et al. Bone Transport for Postinfectious Segmental Tibial Bone Defects With a Combined Ilizarov/Taylor Spatial Frame Technique. J Orthop Trauma. 2011;25:162-168.
  7. Feldman DS, Shin SS, Madan S, Koval KJ. Correction of Tibial Malunion and Nonunion With Six-Axis Analysis Deformity Correction Using the Taylor Spatial Frame. J Orthop Trauma. 2003;17:549–554.
  8. Dammerer D, Kirschbichler K, Donnan L, Kaufmann G, Krismer M, Biedermann R. Clinical value of the Taylor Spatial Frame: a comparison with the Ilizarov and Orthofix fixators. J Child Orthop. 2011;5:343–349.  
  9. Iobst C. Taylor Spatial Frame for Deformity Correction in Children. Oper Tech Orthop. 2011, 21:144-155.