Taylor Spatial Frame application with the aid of a fine wire half frame

In recent years the Ilizarov and more recently the Taylor Spatial Frame (TSF) have come into widespread use both for deformity correction and for the management of acute complex trauma, particularly in the lower limb.1,2,4,5,7 Both systems involve application of circular rings attached to the limb by tensioned wires and/or threaded pins. Optimal mechanical stability is achieved by using the smallest diameter rings while allowing space for the soft-tissue envelope, which may expand further with postoperative swelling. Positioning the rings orthogonal (perpendicular) to the long axis in both coronal and sagittal planes is particularly important in the TSF to minimize error in calculating mounting parameters for the software analysis. A monoaxial fixator can be applied with the limb resting on the table, but for a circular frame the limb must be suspended either by an assistant or by some form of supporting device. We present a technique that provides support for the limb, allowing accurate sizing of the rings with respect to the soft tissues; positions the rings with respect to the long axis of the limb; and has the ability to apply longitudinal traction. The technique described also aids in provisional fracture reduction using ligamentotaxis. It has been our experience that this technique improves the efficiency and ease of application of the TSF, and circular frames in general, to the tibia.