Ilizarov

Definition
• It is a non invasive technique used for
treatment and management of many
disorders starting from simple and open
fractures, deformities, up to untreatable cases
based on tension-stress technique.
• It is also called circular external fixator.
It consist of:
• Rings
• Threaded rods
• Multiple K-wires under tension
Indications
o In fractures
• Can be used as external fixator in closed and open
fractures
o For bone lengthening (distraction
oseteogenesis) that indicated in:
• Leg length discrepancy due to
 Congenital as achondroplasia
 Posttraumatic
 Inflammatory as ch. Osteomylitis
 Malignancy after limb salvage operation
 Paralytic e.g. poliomyelitis
• Dwarfism
o For bone transport to compensate lost bone
segment that indicated in:
• Traumatic : fracture with bone loss
• Inflammatory : after removal of large sequestrated
bone
• Malignancy : after limb salvage operation
• Iatrogenic : during debridement of bone fracture
o For correction of deformities:
• Either congenital or acquired deformities
especially complex deformities
• This is performed gradually by lengthening,
rotation and translation
Advantages
• Less invasive technique
• Less liability for infection
• It is rigid
• Early weight bearing
• High success rate in treatment of poorly
treated or previously treated cases
Disadvantages
• Difficult technique
• Neurovascular impairment
• Laceration of muscles and soft tissue
• Can not be used in mentally retarded person
or those with psychosis
• Bizarre appearance of the apparatus
Contraindications
• Age <3 years
• Mentally retarded or psychosis patient
• Generally bad health of the patient as diabetic
Complication
• Pin tract infection
• Nearby joint stiffness
• Muscle contracture
• Premature consolidation due to delayed
distraction
• Immature consolidation due to accelerated
rate of distraction
• Neurovascular injury
Technique of bone lengthening
By :
1. Callotasis (callus distraction) based on tension
stress technique. Methods:
– Subperiosteal corticotomy
– Periosteal elevation and osteotomy by drilling
Technique of bone transport
• Here we don’t increase the length of the limb but
we just restore the original normal length of the
limb that exposed to condition leading to bone loss
– If the lost segment <10 cm : bone transport achieved in
one direction either proximal or distal to the lost
segment
– If the lost segment >10 cm : bone transport achieved at
2 direction distal and proximal to the lost segment. This
means that corticotomy is done proximal and distal and
distraction is applied at rate of 1mm/day ( 0.25 mm /
6hrs )
Thank you