Perioperative Planning for Two- and Three-Plane Deformities

Primary multiplanar external fixation is efficacious for a variety of fractures and may avoid a salvage situation. Complex deformity in conjunction with fractures, nonunions, and malunions can be measured and corrected with the Taylor Spatial Frame using the chronic and especially the total residual correction methods. Distal referencing—characterizing a deformed proximal fragment with respect to a normal distal fragment—is very useful in most lower-limb salvage cases. Corrections may be performed in stages using way points, and additional total residual corrections may be performed as needed. The same frame and analysis used for gradual correction may be used in conjunction with intramedullary nailing or plating in some cases.