The Taylor Spatial Frame (TSF) fixator is a computer software controlled circular external fixator using six struts, allowing correction of bony deformities, fractures and limb lengthening with great accuracy and ease of use. The TSF fixator consists of tabbed aluminum rings, which are available in size increments of 25 mm in diameter, starting from 90 mm. The basic fixation to the bone is achieved with standard Ilizarov wires or half pins. These are then attached to the rings with wire fixation bolts and cubes with sleeves, etc. Special measurements which allow the software to get oriented to the bone fragment position vis-à-vis the size and orientation of the rings are taken with the help of a translucent grid on X-rays and fed into the software. All patients must have full length or full segment X-rays before and during treatment. The X-ray measurements needed to fill in the software are deformity parameters and mounting parameters. The software takes into account any structure that may be at risk during distraction. Postoperative management and advantages of TSF and difficulties with the Ilizarov fixator are described in detail in this chapter.