TSF

It is an Ilizarov frame with the geometry solved by computer. Two rings sit around the limb, fixed to the bone with wires and half-pins, but instead of straight threaded rods they are joined by six telescopic struts set at angles, the hexapod. Change the six strut lengths in the right combination and one ring moves relative to the other in any direction: lengthen, tilt, slide, rotate.

The surgeon measures the deformity and the frame position on X-rays and enters those numbers into a web-based program. The software returns a prescription: a table of what each strut should read on each day. The patient or a carer turns the struts to those numbers. Bone forms in the widening gap exactly as it does under an Ilizarov frame; only the steering has changed. If the end position is not quite right, the surgeon takes new X-rays and runs a residual correction instead of rebuilding the frame.

The TSF was developed by Charles and Harold Taylor in 1994 and is the original hexapod; TrueLok Hex and Orthex are later members of the family.

The patient whose bone is short and bent, twisted or displaced at the same time. In a Vienna study of 208 lower-limb deformity corrections, the planned correction was achieved in 90.7% of TSF cases against 55.7% with the Ilizarov ring fixator, and the gap widened as deformities got more complex: for three-dimensional corrections the figures were 91.1% versus 28.6%. That accuracy is the reason to accept a hexapod's bulk. Smith+Nephew lists congenital deformities, acquired deformities from trauma, infection or cancer, and fractures as its uses; much of the published experience is in children and in post-traumatic reconstruction.

For a healthy adult who wants height and has straight bones, the hexapod solves a problem you do not have. The Taylor Spatial Frame does not appear by name anywhere in the largest review of cosmetic stature lengthening, Marwan 2020, with 795 patients. If a clinic proposes a TSF for a purely cosmetic case, ask what deformity they intend to correct with it.

After a latency period, distraction runs at about 1 mm a day, but the daily instruction is a set of six strut readings rather than one turn on each rod, so following the schedule exactly matters. Struts have a working range; when one runs out it is exchanged, which is routine but adds visits. Typical gains on this page are 3–8 cm.

Time in the frame is long because the TSF, like Ilizarov, stays on through consolidation. Smith+Nephew tells patients that most wear the device for four to twelve months. In a paediatric series of tibial lengthening and correction, TSF patients spent a median of 230 days in the frame for a mean of 54 mm of length, a healing index of 41 days per centimetre. In a 135-correction comparison, distraction-consolidation time was shorter for the TSF (148 days) than for the Ilizarov (204 days) or the Orthofix fixator (213 days), although the healing index of 57 days per centimetre did not differ between devices. Pin-site care is daily for the whole period, and physiotherapy runs alongside.

Pin-site infection is the defining risk here as with every frame, and the hexapod's long wear time gives it months to happen. In the paediatric comparison above, pin-site infections occurred in 40% of the TSF group against 18% with the Orthex hexapod; in the 135-correction study both ring fixators had more pin-related problems than the unilateral Orthofix device. Most are minor and settle with dressings and antibiotics, but every one has to be caught early.

The frame itself is heavy and awkward: day-to-day discomfort is greater than with an internal nail, sleep and clothing are affected, and strut exchanges mean extra procedures. Joint stiffness, nerve irritation and slow or poorly formed regenerate can occur with any lengthening. Software steering does not remove human error: mounting parameters measured wrongly produce a wrong prescription, which is why residual corrections exist. No cosmetic-only complication series for hexapod lengthening turned up in our source search, so do not accept a clinic's Ilizarov or nail figures as a stand-in.

Above a plain Ilizarov frame, by a margin large enough that the authors of the 135-correction comparison wrote that, despite its accuracy, the TSF had not become their routine device because of its remarkably higher costs. The six struts and the software planning are proprietary; standard rings and rods are not. Against a motorised nail the picture is less clear and depends on the hospital's implant pricing, so ask for the hardware line separately.

The bigger cost driver is time. Four to twelve months in a frame means more clinic visits, more X-rays, strut exchanges, months of pin care and a long spell away from work; a travelling patient must decide whether to stay near the clinic or manage the frame at home with local follow-up.

This page carries no prices on purpose. The cost guide and each clinic listing do, and they are updated separately.

Start with the indication. If your goal is height alone, ask which deformity the hexapod is for; if there is none, ask why not a nail, LON or a plain frame. Legitimate reasons exist: an angular deformity, a narrow canal, a history of bone infection. "We use it for everything" is not one of them.

Then ask about the software. Who enters the mounting parameters, who reviews the prescription, how often X-rays are repeated, and how residual corrections are handled. Ask how many strut exchanges a typical case needs and whether they are included. Ask which hexapod they use, TSF, TrueLok Hex or Orthex, and why; the two systems compared in the paediatric study differed in pin-site infection rates.

Finally, ask about time and support: expected months in the frame, the pin-site protocol in writing, who follows you if you go home with the frame on, and what removal involves. Clinic profiles here list the methods each centre performs; a hexapod-only centre has one answer to every question.