Computer-assisted Taylor spatial frame for correcting malalignment after unilateral external fixation of tibial fractures

This study aimed to evaluate the clinical efficacy of computer-assisted Taylor spatial frame (TSF) for correcting malalignment after unilateral external fixation (UEF) of tibial fractures. This retrospective cohort study included 18 patients with tibial misalignment after UEF between February 2019 and February 2024. Using the TSF technique, X-ray parameters (deformity, frame, and mounting) were entered into software to generate a six-axis correction prescription. Reduction time, number of X-ray exposures, total external fixation duration, clinical fracture healing time, complications, and functional recovery were recorded. The Wilcoxon signed-rank test was used to compare preoperative and final visual analogue scale (VAS) scores because the paired differences were not normally distributed; data are presented as mean (range) or median (interquartile range [IQR]). All 18 patients were followed up for a mean of 14.9 months (range: 12-18 months). Satisfactory reduction was achieved in all cases after TSF adjustment. Mean reduction time was 19.0 minutes (range, 15-24 minutes), and patients received a mean of 1.4 X-ray exposures (range, 1-3). Clinical fracture healing occurred after a mean of 24.0 weeks (range, 21-29 weeks), and total external fixation lasted a mean of 25.2 weeks (range, 22-30 weeks). Johner-Wruhs ratings at final follow-up were excellent in 15 patients and good in 3 (100% excellent/good). Median VAS scores improved from 7 (IQR, 6-8) before surgery to 1 (IQR, 0-2) at final follow-up (Wilcoxon signed-rank test, Z = -3.77, P < .001). Superficial pin tract infections developed in 3 patients (16.7%; 3/18) and were controlled with oral antibiotics and dressing changes. No patient had deep infection, pin loosening, nonunion, or bone exposure. In this small, single-arm retrospective cohort, all 18 patients achieved satisfactory reduction with computer-assisted TSF, and adjustment times were short. No patient underwent secondary open reduction or fixation. These preliminary findings suggest that TSF may serve as a feasible minimally invasive option for correcting early malalignment following UEF of tibial fractures; however, multicenter controlled studies with longer follow-up are needed to confirm these results.