Ilizarov Apparatus

The Ilizarov Apparatus is comprised of external fixators such as rods, Kirschner’s wires and rings. The Ilizarov apparatus is unlike the conventional external fixators. Those fixators consist of the limb just like in the shape of a cylinder and makes use of wires instead of pins so as to fix the bone to the rings.

The Ilizarov’s Principle of Distraction Osteogenesis is used for Ilizarov Limb Lengthening Method. The new bone is introduced in between the bone surfaces which has been carefully and gradually pulled in a controlled manner. The Neovascularisation is the result of the initial distraction that stimulates the formation of a new bone. Simultaneously, there is histogenesis of skin, muscles and nerves. The new bone in bone diseases (pseudo-arthrosis, osteomyelitis and fibrous dysplasia) replaces the pathological bone with the normal bone. This is regarded as the revolutionary concept and with the help of Ilizarov Technique, many diseases are successfully treated that earlier had no treatment.

Indications for ilizarov technique

Some bunions occur over the years while the other may progress rapidly. Some bunions are painful while the others are not and not this does not depend on the size. Following are the causes:

Indications for ilizarov technique

• Comminuted fractures in the limbs and also with skin loss
• Correction of both acquired and congenital deformities of the limbs
• Height increase (specially for dwarfs)
• Bone infections
• Poliomyelitis Sequelae (correction of deformities and limb lightening)
• Treatment of malunited fractures and of non-unions

Ilizarov limb lengthening Procedure

Transosseous Osteosyntheis is the other name used for limb lengthening procedure. By making use of drill, the 1.5 mm diameter wires are then passed through the skin and bones. The extended ends of the wires are fixed to rings with unique wire-fixation bolts. All these rings are fixed and connected with each other with the help of threaded rods. When the rings are properly fixed, the Ilizarov frame gets a steady support to the affected limb. The Corticotomy procedure is then performed which means cutting the bone (osteotomy) where the bone’s periosteum is preserved. The distraction is produced by making adjustments in the rods as preferred in between the bone ends and all the deformities also gets corrected. After the procedure the external ring fixator is also removed.

• Intensive physiotherapy is used early as the result of which the problems of joint contractures and stiffness are considerably rare. Along with this the stay of the patient in the hospital is also reduced.
• In conventional operation, there is no skin incision. Incidents of tissue trauma, infections and hemorrhage are much lesser.
• The entire procedure is minimally invasive as it involves less tissue damage and wires are used to fix the bones to the rings.
• The cylindrical shape fixator simultaneously corrects deformities in three dimensions.

Leg Shortening Surgery

This surgery is also known as bone shortening, femoral lengthening, bone lengthening and femoral shortening. The aim of this surgery is to correct LLD and connected deformities by protecting the function of joints and muscles. The surgery is done for-

• An abnormally long leg is shortened by the means of this surgery. The patients whose bones are no longer growing (skeletal maturity) are usually indicated by this surgery.
• The surgery is performed to allow the growth of a short leg of matching length by limiting the growth of a normal leg.
• The surgery is done to lengthen an abnormally short leg (femoral lengthening or bone lengthening). The surgery is recommended for those children whose bones are skeletally not mature. The surgery can add at most 15.2 cm in length.

Causes of leg length inequality

• Tight and short muscles
• Birth defects of joints, tendons, ligament or bones
• Cerebral palsy, septic arthritis or poliomyelitis
• Weak small muscles
• Hip diseases
• Scoliosis (abnormal spine curvature)
• Bone fractures and previous injuries that have stimulated extra bone growth

Cosmetic Limb Lengthening

Height lengthening (limb lengthening) is a modern day procedure and this minimally invasive procedure is performed by making a surgical cut in the thigh bones or in the leg, in order to promote the mending and lengthening of any leg deformities. The deformity correction technique is used to replace the missing bone or to straighten or lengthen the bone deformed segments. Both children and adults can benefit from this procedure and it eliminates deformities which is due to injuries, birth defects, knock-knee deformities, trauma and the bow-legged patients having one leg shorter than the other leg. Distraction Osteogenesis is the procedure by which the correction of deformities and lengthening of the bones is done when there is gradually growing of soft tissue sand new bone.