Ilizarov: Solution for most Orthopedic problems
History shows that some of the inventions have proved to be milestones, which are very useful in developing different technologies. In this chain, the inventions of Gabriel Ilizarov have been proven very important in the treatment of orthopedic problems. Gabriel Ambramoich was born in Poland and was educated in Russia and established the Kurgan Research Institute in Russia which is the biggest research Institute for Orthopedics so far. He developed the concept of distraction osteogenesis and Illizarov techniques.
In this technique, a bone is cut into two halves and if the distance between the two is increased slowly then there is new bone formation between the ends which is converted into normal bones within a few months. On the other hand, when we compress the bone slowly then nonunion even with infection, the bone gets united. For slowly separating two ends of bone thin wires and rings are used, both ends of the bone are kept inside rings and are connected to rings via wire.
Initially, this technique was used in uniting bone nonunion but now this technique is used in various orthopedic problems like bony nonunion, malunion, congenital bony malformation, lengthening of small limbs, increasing height of dwarfs, uniting multiple comminuted fractures, making of bone in absent bones and uniting infected fractures. Besides this, it is also used in burger disease in which there is reduced blood circulation in the legs. In this technique, all the equipment is outside the body.
This technique works on many principles. In the first principle, it is seen that if a bone is cut at one place and is slowly moved at the speed of 1 mm per day and the distance between two bones is increased then there is new bone formation between two bones which becomes normal bone. It is also seen when the distance between is increased, new blood vessels are formed, which facilitates early reunion of bones, and in Burgers disease blood circulation is started.
This instrument and principles of Illizarov have been proven very useful in increasing bone and muscle length, correcting limb deformity, correcting various orthopedic problems and deformities, correcting infected bones, and uniting bones nonunion.
After this many improvements have been made in the Illizarove technique. First is a Hybrid fixator in which a thick pin is used in place of thin wires which causes less pain. A rail system is also developed in which a thick pin is used in place of wire and a straight carbon plate is used in place of
rings. This facilitates movement in patients and reduces problems. these days Ilizarov’s principles are improved and made easier.
In a more advanced manner, the rod is put inside the bones and is attached to the rail system, and the length between the bone ends is increased. When length is completed the outer rail system is removed and the rod between the bones is fixed with a screw to the bones. In all these types of Illizarov techniques, there is no or very little need for an incision during operation which reduces bleeding and the patient starts moving very soon.
After the operation, special care must be taken for the cleanliness of wires, rods, and rings, and after the operation, the patient starts taking his weight and starts moving very soon. nowadays this system is also supported with computer software which has made treatment of difficult orthopedic problems possible.
Reference link –
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025247/
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03335-w
