External frames to correct bone deformities

ILIZAROV AND TAYLOR SPATIAL FRAMES

Our orthopaedic surgeons use advanced surgical apparatus to correct your child's bone deformity

About external frames

The frame can be used to fix a number of bone abnormalities and reconstruct the limb.

Primarily, the frame helps to mend complex fractures that have failed to heal (non-union) or failed to heal correctly (mal-union).

In children, it's used to lengthen bones and correct limb deformity, where one bone is longer than the other. This is often caused by unhealed growth plate injuries, usually in the shin bone (tibia), which can affect the back and surrounding joints too.

The frame itself is a set of circular stainless steel rings held together with rods and adjustable nuts. They're fixed to the bone itself and surround the limb. By tightening the nuts and rods and applying tension, the bone and soft tissue can be regenerated.

A variation on the Ilizarov frame is the spatial frame, which is used alongside software. The frame is adjusted daily for quicker recovery.

Need to know

What happens during frame surgery?

This procedure is carried out under general anaesthetic, so your child will be asleep throughout. If the frame is being used to lengthen the limb, a cut may be made in the bone to stimulate healing and generate new bone cells.

The frame is then added. Around four to six rings are used (depending on the limb being operated on). These are then fixed to wires which pass through the skin, into the bone and out the other side of the limb. These wires are fixed to to the frame under tension. A circular cage now encases the limb. The length of operation depends on which limb is receiving the frame.

How to prepare for frame surgery

Your consultant will explain the procedure and answer any questions you have. In the week before surgery, it’s important that your child stays healthy.

Let your consultant know if your child has recently had a cold or a sore throat, as surgery may need to be postponed to reduce the risk of complications. Because general anaesthetic is used during the procedure, your child may need to fast for several hours before the operation.

Your consultant will tell you how long they should avoid eating and drinking. Like all procedures, there may be some risks and side effects. Your consultant will explain these to you.

Afterwards

Your child will wake up with the frame around their limb, which will be quite swollen. They may have received nerve blocks during surgery to reduce pain, so their limb may feel a little tingly. Pain from surgery will reduce gradually. If the frame is being used to extend the bone, then you'll need to tighten it four times a day with a special spanner. Your consultant will tell you how this works and what to do. Your child will need to attend frame clinics on a regular basis, throughout their treatment (usually every two to six weeks). When the treatment is completed, they'll need further surgery to remove the frame.