Idea is to use TSF on the femur but leave the thigh outside the frame, attach the frame to half pins in the femur and than use it as a standard frame for deformity correction purposes. There are certain limitations:
Because of the chronic osteomyelitis decision was made not to internally fix the pathological fracture but continue with external fixation. Existing external fixation did not offer enough stability neither an option to fine tune the reduction outside the theatre hence we were looking for different options. "Eccentric" TSF was discussed and agreed prior to the application between consultant colleagues and the patient.
16 May 2018
Existing frame was removed, additional half pins inserted and TSF assembled using 80mm rings. Proximal ring was mounted as close to 90 deg to the anatomical femoral axis as possible.
At this stage TSF prescription was prepared as standard one taking into account trigonometrical requirements.
22 May 2018
After only a few days of running the prescription X-rays confirmed improvement but also that the theory is working in practice. Great.
01 June 2018
Femur is straight. In both planes. It worked nicely, exactly as predicted.
Mr Matija Krkovic, MD, PhD
I am Consultant Orthopaedic Trauma Surgeon with special interest in Limb reconstructions and bone infections.