In medicine, the Ilizarov apparatus is a type of external fixation apparatus used in orthopedic surgery to lengthen or to reshape the damaged bones of an arm or a leg; used as a limb-sparing technique for treating complex fractures and open bone fractures; and used to treat an infected non-union of bones, which cannot be surgically resolved. The Ilizarov apparatus corrects angular deformity in a leg, corrects differences in the lengths of the legs of the patient, and resolves osteopathic non-unions; further developments of the Ilizarov apparatus progressed to the development of the Taylor Spatial Frame.
Dr. Gavriil Abramovich Ilizarov developed the Ilizarov apparatus as a limb-sparing surgical remedy for the treatment of the osteopathic non-unions of patients with unhealed broken limbs. Consequent to a patient lengthening, rather than shortening, the adjustable-rod frame of his external-fixation apparatus, Dr. Ilizarov observed the formation of a fibrocartilage callus at and around the site of the bone fracture, and so discovered the phenomenon of distraction osteogenesis, the regeneration of bone and soft tissues that culminates in the creation of new bone.
In 1987, Dr. Victor Frankel introduced to U.S. medicine the Ilizarov apparatus and Dr. Ilizarov's surgical techniques for repairing the broken bones of damaged limbs. The mechanical functions of the Ilizarov apparatus derive from the mechanics of the shaft bow harness for a horse.
The Ilizarov apparatus is a specialized external fixator of modular construction, composed of rings (stainless steel, titanium) that are transfixed to healthy bone with Kirschner wires and pins of heavy-gauge stainless steel, and immobilised in place with additional rings and threaded rods that are attached with and through adjustable nuts. The circular construction of the apparatus, the rods, and the controlled tautness of the Kirschner wires immobilises the damaged limb to allow healing.
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External fixation is a surgical treatment wherein Kirschner pins and wires are inserted and affixed into bone and then exit the body to be attached to an external apparatus composed of rings and threaded rods — the Ilizarov apparatus, the Taylor Spatial Frame, and the Octopod External Fixator — which immobilises the damaged limb to facilitate healing. As an alternative to internal fixation, wherein bone-stabilising mechanical components are surgically emplaced in the body of the patient, external fixation is used to stabilize bone tissues and soft tissues at a distance from the site of the injury.
Nonunion is permanent failure of healing following a broken bone unless intervention (such as surgery) is performed. A fracture with nonunion generally forms a structural resemblance to a fibrous joint, and is therefore often called a "false joint" or pseudoarthrosis (from Greek pseudo-, meaning false, and arthrosis, meaning joint). The diagnosis is generally made when there is no healing between two sets of medical imaging, such as X-ray or CT scan. This is generally after 6–8 months.
Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the mid-twentieth century. An internal fixator may be made of stainless steel, titanium alloy, or cobalt-chrome alloy. or plastics. Types of internal fixators include: Plate and screws Kirschner wires Intramedullary nails Open Reduction Internal Fixation (ORIF) involves the implementation of implants to guide the healing process of a bone, as well as the open reduction, or setting, of the bone.
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