Ilizarov apparatus
Instructions for use:
- 1. Installation
- 2. Advantages and Disadvantages
- 3. Removal
The Ilizarov apparatus was created in the early fifties of the twentieth century by the famous Soviet surgeon G. A. Ilizarov. The apparatus, made by Ilizarov, consists of four skeletal traction metal spokes fixed on two rings and interconnected by movable rods. Over the years, this device has been gradually improved. The modern Ilizarov apparatus is made of titanium with a high strength index. Modern designs use titanium or carbon fiber rods instead of spokes. Rigid rings in it are replaced by plates, semicircles and triangles. A modern medical device that is quite lightweight and small in size is widely used in traumatology, in aesthetic medicine and orthopedics to correct body proportions, curvature of the legs, congenital deformities, clubfoot,anomalies in the development of the bones of the foot. This device is used for rickets, pseudoarthrosis, for fractures of various localization and complexity, as well as for increasing growth in systemic diseases of the skeleton, for treating joint contractures, for eliminating defects in soft tissues and bones that have arisen after tumors, infections or injuries.
Installation of the Ilizarov apparatus
The Ilizarov compression-distraction apparatus is designed for distraction (stretching) or compression (squeezing), as well as for long-term fixation of individual bone fragments. With any fracture, the edges of the bones can move as the muscles pull them in different directions. The use of the Ilizarov apparatus on a leg or arm in case of a fracture prevents the displacement of bone fragments. It reliably fixes non-fused fractures and false joints and does not require additional plaster immobilization. Along with the treatment of pseudoarthrosis and nonunion fractures, the device is successfully used to correct the length of the limb.
The process of installing the Ilizarov apparatus on a leg or arm with a fracture is as follows. Through each bone fragment in the area of the fracture, a drill is used to pass two knitting needles, crossing them at right angles. A pair of needles of each bone fragment is fixed and fixed in a ring (half ring) using a special key. When tightening the nuts on the movable rods, the distance between the rings changes. The convergence of the rings provides compression between the edges of the fragments. Due to the deformation of the spokes, the compression force gradually decreases. Therefore, the spoke tension must be monitored and adjusted daily. Skillfully manipulating the movable rods, it is possible to eliminate the displacement of fragments along the axis, angular deformities, and also to perform closed reposition of bone fragments.
Leg lengthening with the Ilizarov apparatus is carried out in stages. First, an apparatus is applied to the patient, then the bone is dissected (osteometry) and the fragments are fixed using an orthopedic apparatus. The gradual lengthening of the legs (distraction) begins about a week after surgery. The lengthening rate of the limbs is one millimeter per day. The rate of distraction depends on the patient's individual tolerance for this procedure. Thus, the duration of distraction when the limbs are lengthened by five centimeters is from 50 to 75 days. The fixation period begins after the end of the leg lengthening period. Usually the fixation period lasts twice as long as the distraction period.
After about a month, surgery is performed on the second limb. Limb lengthening operations are performed under general anesthesia. The patient can walk with crutches already on the second day. During the rehabilitation period, the patient is advised to swim and walk.
The Ilizarov apparatus is also used to eliminate the curvature of the limbs. During the operation, the bone is dissected at the site of its deformation, and then fixed in the correct position using an apparatus. The installation of the Ilizarov apparatus consists in passing the wires through the bones and inserting the rods. Correction of the shape of the legs can be either gradual (deformity is eliminated with daily correction), and one-step (correction is carried out right during the operation). The daily correction is done by the patient himself. The device is removed after the bones have grown together in the correct position. Modern Ilizarov apparatus; are relatively small, so the patient can fully move almost immediately after the operation.
Advantages and disadvantages of the Ilizarov apparatus
Installation of the Ilizarov apparatus makes it possible to shorten the time of fracture healing and reduce the likelihood of developing a pseudarthrosis to almost zero. Partial load on the injured limb is possible already on the second or third day after the procedure.
However, this device also has its drawbacks. Rings often interfere with sitting and lying normally. Pinpoint scars remain in the puncture sites after removal of the device. Some reviews of the Ilizarov apparatus say that when using it, many patients develop swelling and aching pain that interferes with sleep.
Removing the Ilizarov apparatus
Only a specialist can remove the device. As the reviews say, the Ilizarov apparatus is most often removed without preliminary anesthesia.
After removing the Ilizarov apparatus, small wounds remain on the injured limb, which heal rather quickly. To speed up healing, wounds can be treated with disinfectants. Over time, almost invisible scars remain in the places of the removed apparatus.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
