Firstly, should we learn about what ILIZAROV surgery actually is?
ILIZAROV surgery which has originated in Russia is an orthopedic surgery using a type of external fixation to lengthen and reshape limb bones; as a limb sparing technique to treat complex or open bone fractures.
It uses a type of external apparatus called ILIZAROV Apparatus to lengthen and reshape limb bones; as a limb-sparing technique to treat complex or open bone structure; and in any cases of infected non-unions of bones that are not amenable with other techniques
Some facts about Russian ILIZAROV surgery are as follows:
- The ILIZAROV frame takes its name from Dr Gavril Abramovich Ilizarov. He was born in the Soviet Union in 1921 and attended medical school in Crimea aged 18. Having graduated in 1944, his first job was as a family doctor in the Kurgan province of Northern Siberia. As this was a remote area, Ilizarov worked largely alone, and was required to perform a range of surgical procedures and while working on these procedures, he invented this ILIZAROV surgery.
- No matter what condition or defect is being treated by the use of an ILIZAROV fixator, the fixator and how it works is broadly the same. The ILIZAROV apparatus is a set of external fixators consisting of rings, rods and kirschner wires, all made of stainless steel. It differs from the conventional external fixators in that it encases the limb as a cylinder and it uses wires instead of pins to fix the bone to the rings. The top rings of the ILIZAROV fixator allow force to be transferred through the external frame, bypassing the fracture site and transferring the force from healthy bone to healthy bone.
- The purpose of the ILIZAROV fixator is to stimulate bone growth, and this works by the principle of distraction osteogenesis, which is the pulling apart of bone to stimulate new bone growth.
- The ILIZAROV method carries many advantages over other methods for limb reconstruction. One of the main advantages of distraction osteogenesis is that it is effective in mature as well as young bone, which means treatment using this principle is not limited to children, but works equally as well in adults. The ILIZAROV external circular fixator is a very useful tool for many reasons:
- The modular design of the apparatus allows the frame to be custom built for each individual patient.
- The circular nature of the frame both enhances stability and evenly distributes the stress across the corticectomy and the distraction gap.
- The structure and strength of the frame allows weight bearing throughout the treatment, which is beneficial to the patient both in terms of day-to-day mobility and helping to build muscle strength and prevent joint stiffness.
- When the frame is applied to the limb during surgery, only wires fix the bones to the rings, and no other skin incisions are made, which reduces the risk of bleeding, infection, and damage to the surrounding soft tissues.
- It holds fragments of bone together to allow them to unite when traditional methods of fixation are unable to give proper hold on the fracture fragments, and allows significant compression in the case of non‐unions.
- It allows bone fragments to be pulled apart. This results in osteogenesis and can be used for limb lengthening or for regenerating bone which has been removed due to traumatic loss, tumor or infection.
- The ILIZAROV technique is hugely complicated and requires a great deal of expertise to perform successfully. Extensive knowledge of human anatomy is essential, in order to reduce the risk of nerve or vascular damage. The vast amount of time it takes to acquire the necessary training means there are few surgeons suitably trained to perform this technique. Although laborious, when successful, the ILIZAROV method is of dramatic benefit to the patient.