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Ilizarov Surgery

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Ilizarov surgery is an orthopaedic technique that uses a circular external fixator (Ilizarov apparatus) to treat complex bone conditions such as fractures, deformities, limb length discrepancies, and bone defects.
The method works on the principle of distraction osteogenesis, where new bone forms gradually when two bone segments are slowly pulled apart.

The technique was developed by Russian orthopaedic surgeon Gavriil Ilizarov.

Principle: Distraction Osteogenesis

After a controlled bone cut (corticotomy/osteotomy), the bone segments are gradually separated at about 1 mm per day using the external frame.
This slow stretching stimulates new bone formation, soft tissue growth, and blood vessel development.

Components of the Ilizarov Apparatus
  • Circular metal rings placed around the limb
  • Thin tensioned wires or pins passing through the bone
  • Connecting rods joining the rings
  • Adjustable nuts and screws to gradually move bone segments
Indications

Ilizarov surgery is used for:

  • Complex fractures and non-union
  • Bone defects after infection or trauma
  • Limb length discrepancy
  • Angular deformities (varus, valgus, rotational deformities)
  • Congenital limb deformities
  • Infected non-union and osteomyelitis
Basic Procedure Steps
  1. Application of circular frame around the limb.
  2. Insertion of thin wires/pins through the bone and fixation to rings.
  3. Controlled bone cut (corticotomy).
  4. After a short waiting period, gradual distraction begins.
  5. New bone forms in the gap while alignment or length is corrected.
Advantages
  • Can correct complex deformities in multiple planes.
  • Allows simultaneous bone lengthening and deformity correction.
  • Preserves blood supply to the bone.
  • Useful in infected non-union where internal implants may not be suitable.
Recovery
  • Patients may walk with the frame in place depending on the condition.
  • Frame usually remains for several months until new bone becomes strong.
  • Regular adjustments and follow-up X-rays are required.
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Possible Complications
  • Pin tract infection
  • Joint stiffness
  • Pain during distraction
  • Delayed bone consolidation

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    Ilizarov surgery is a powerful limb reconstruction technique widely used in orthopaedic trauma and deformity correction, especially when conventional fixation methods are not sufficient.