Dr Bagirov (Moscow, Russia) Clinicanomer1

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External Ilizarov Method  (Translated From Russian Text)

In our clinic, we perform surgeries aimed at lengthening the legs using low-trauma techniques with improved designs of the Ilizarov fixator. The success of the procedure and its safety largely depend on the quality of the preoperative evaluation. Computed tomography is utilized to identify all the dimensional characteristics of the legs: the length of each leg segment, their proportions down to the millimeter, and the condition of the hip, knee, and ankle joints. The procedure involves the installation of the Ilizarov fixator on the shin, intersecting the tibia and fibula at various levels. Subsequently, using external frameworks (sets), the patient independently (with the aid of simple devices) stretches the shin bone at the intersection. The growing callus fills the widening gap created, resulting in the lengthening of bones.

The day after the surgery, the patient is able to stand and walk independently using “walkers.” This progresses as follows: 5-6 days after initiating the stretching of the bone tissue (distraction), done by twisting the screws in the device at a certain rhythm and pace, specifically calculated for each patient using a special computer program. The distraction (stretching) speed for leg elongation is set at 0.5 – 1 mm daily and occurs in two or four receptions of 1/4 turn of the nuts per day, respectively.

In the elongation zone, regenerate bone is formed, which increases the length during distraction. After the elongation (distraction) period, there is a necessary time for the complete ossification (ossification) of the newly formed regenerate.

The duration of the use of external fixation devices is determined by the extent of the elongation of the lower extremities (the greater the length, the longer the fixation time), along with individual patient characteristics (sex, age, presence of chronic conditions), averaging from 6 to 12 months.<