Ilizarov frames are a specific method for healing fractures that are either nonunion (nonhealing) or are purposely created in bone to allow lengthening of the affected bone. In both cases, the Ilizarov frame is used around the fracture for the management of bony deformities, fractures and complications.

The frame resembles a tinker toy set and is supported by several adjustable links which are able to be lengthened during the course of bone healing. When the patient has the Ilizarov system on, it looks as though someone has performed some type of mad surgery on them, when in fact the patient is experiencing one of the most exciting methods of orthopedic recovery.

In 1968 Valerie Brumel, an Olympic champion high jumper at the 1964 games visited Dr. Ilizarov, having suffered a compound fracture of his distal tibia in 1965 and despite 20 operations over 3 years had developed an infected nonunion fracture and significant leg length discrepancy. His resultant surgery by Dr. Ilizarov was a widely publicized success and gained the doctor recognition within the Soviet Union.

The technique was labeled “distraction osteogenesis” and was studied on dogs prior to being used on humans. Dr. Ilizarov found that the bone could be lengthened up to 10% but that attempts to lengthen the bone over 30% caused problems with nerves, arteries and veins. The cartilage also underwent changes including reduced thickness and problems within the joint cartilage.

The rings of an Ilizarov fixator are something you will never forget once you see them. They provide a framework from which the orthopedic surgeon can drill several wires and the rings can be separated from each other such that a force can be applied to the fracture site. Once the frame is constructed around the limb the caregiver can adjust the Ilizarov frame up to 1 mm per day by turning several adjustable struts. The bone is supported by several wires drilled through the bone to provide force to both sides of the system.

I had the unique opportunity to work with a patient with an Ilizarov system as a young therapist years ago when a young man with a leg length discrepancy was brought to the clinic. The doctor had made an artificial fracture in the bone and put an Ilizarov system on his leg. Rather than have a large difference in leg length or wear large lifts in the shoes, the doctor had corrected the difference in leg length using the Ilizarov system. I had the opportunity to adjust the bone and work with the patient through the rehabilitative process while the bone healed. After quite some time, the bone had been lengthened approximately an inch and a half to provide satisfactory lengthening.

This fascinated me since my early days as a therapist and I have not worked with one since. However, this method always made me think about new horizons in the orthopedic stratosphere that could be reached. Although the patient that I saw had a disease of the cartilage growth plates, the application of distraction osteogenesis is something that can be used for fractures and for bone lengthening alike.

For more information on distraction osteogenesis and the Ilizarov method, you can find a picture of the system at the National Library of Medicine at ncbi.nim.nih.gov/pmc/articles/pmc3025247/.

Thanks and have a great day.

We invite you to use our commenting platform to engage in insightful conversations about issues in our community. We reserve the right at all times to remove any information or materials that are unlawful, threatening, abusive, libelous, defamatory, obscene, vulgar, pornographic, profane, indecent or otherwise objectionable to us, and to disclose any information necessary to satisfy the law, regulation, or government request. We might permanently block any user who abuses these conditions.