Limb reconstruction circular frames

How do the frames work?

To help limb correction to take place, the metal frame is attached around your child’s limb. This is done by passing metal pins through the skin, muscle and bone. At the same time a break is made in the bone. Once the frame is in place, the broken bone can be moved over time by making small alterations to the frame.

What frames are available?

We currently use 3 types of circular frames to correct limbs:

The Ilizarov frame is altered by turning marked nuts on a metal rod, in the direction of a marked flag.

The Taylor spatial frame is altered by turning numbered, colour-coded ‘struts’.

The Orthex frame.

Making turns

Your child will be given a programme of ‘turns’ which will have to be done at different times of the day.

The ‘turns programme’ for the Ilizarov frame will be handwritten using a sheet like the one shown below.

The turns programme for the Taylor spatial frame is computer generated from based on information about your frame and treatment.

Your child’s turns should always be done as instructed and should never be stopped without consulting the PLRS team or your child’s consultant.

Once the limb is in the correct position, the turns can be stopped. The frame must then stay in place while the bone heals. This process might seem quite overwhelming at first, but the children and young people quickly adapt to having a frame on their legs. Any discomfort usually settles after a few days, and doing the turns become part of your daily routine.

How long will treatment take?

Limb reconstruction treatments can take a relatively long time to complete, generally between 6 months to 1 year. The treatment will have a big impact not only on your child’s life, but also that of the whole family.

If having their lower limbs corrected, your child will be expected to walk as much as possible throughout the treatment.

To begin with, this will be with a walking frame or crutches. A wheelchair may be needed for long distances.

The physiotherapist will make sure that your child is walking safely before they are discharged from the hospital.

After your child has been discharged, they will need to come to regular physiotherapy sessions at their local hospital.

What about school?

We strongly recommend your child continues to go to school wherever possible, because the treatment can take so long. We will send a letter to your child’s school or community nurse to let them know about your child’s treatment. However, it is always useful if you can speak to school as well, so school routine can be adapted as necessary.

Your child will have regular reviews during their treatment, so they may miss some school time. To begin with, they will visit the outpatients clinic every week or every 2 weeks, and then appointments will be every month.

Daily care

There are some daily care tasks you will need to do with your child every day.

These include cleaning the skin around each pin site to reduce the risk of possible infection (please see our Looking after your pin sites information resource for more information), physiotherapy exercises and doing the turns programme.

We will make sure you understand all these tasks before your child is discharged from hospital.

Our aim is that treatment should cause minimal disruption to your lives. Children are usually in hospital between 6 to 10 days, and the rest of the treatment is home-based and family centred. We therefore rely on the children or young people and their carers being largely responsible for their own care.

Your child should not have to do anything in their treatment that will disrupt their school day too much. Most tasks can be done before or after school.

Research shows that smoking seriously disrupts bone healing. We strongly recommend that you and other adults do not smoke around your child, and that if your child does smoke that they stop.