1952 – the date of the development apparatus, called by its Creator – G. A. Ilizarov, which made a revolution in medicine and began a new era in traumatology and orthopedics. The design is widely used in the treatment of fractures and their complications. The device allows you to compress and decompress your bones, preventing disability and restoring health.
Ilizarov – what it is
Simple construction – the compression-distraction apparatus is made of metal. The system is based on rods (spokes) of titanium or carbon fiber, which pass through the bone fragments at an angle of 90 degrees. Metal rods are attached to the rings movable transition elements which can change the length of the device. As a result, the doctor is able to compress or stretch the sections of the bone requires treatment.
Ilizarov – application
When squeezing occurs hard compression and tensile – splitting. Therefore, the device is called a compression-distraction, and the process of therapy is compression-distraction osteosynthesis. Medicine is constantly improving the device and application of Ilizarov frame was extended for the solution of many problems such as:
- fractures of varying complexity;
- about the joints;
- systemic disease of the skeleton;
- varus deformity of the knee;
- insufficient growth;
- the need to fix the proportions of the body, the curvature of the legs and to solve other problems in aesthetic medicine.
Apparatus for bone fusion
One of the purposes of modern design of the Ilizarov method – fix the fragments of bone fractures. Apparatus for bone fusion are used in an open and multisplintered the form of fracture. The risk of displacement of fragments causes the probability of losing contact with bone, wrong seam. A device that regulates the distance between the tissues, increases the rate of fusion. The main advantage – firmly fixed the fracture to keep the bones properly fused. Even if the device is superimposed on the tibia, and the patient can walk without waiting for a full recovery.
The lengthening of the foot by Ilizarov
The length of the legs determine bone: to change it, you want to compromise the integrity of the limbs. This broken bones in the thigh or lower leg, and after the needle is inserted in the break. Distance adjustment nuts increases the distance, lengthening the bone. In the average day rate of distraction (traction) is 1 mm. For a period of two months to spend the increase of 6 cm After the distraction period to be a period of fixation, the usual duration of which is 2 times larger than the time extension of the legs.
The use of compression-distraction devices in orthopedics justified medical and aesthetic indications. The process of distraction is prolonged. From 6 to 12 months the patient will need to use devices to increase the length of the legs and allow to harden young tissues. Distraction causes pain, requires constant medical supervision and long rehabilitation. Doctors recommend thoroughly acquainted with the methodology, study photos and videos for fixing and wearing the compression-distraction device before deciding on the surgery.
The installation of the Ilizarov apparatus
Although small, the design looks simple, the process of installation requires General or regional anesthesia to temporarily block the conduction of nerve plexus area of production. Above the fracture perpendicular to each other put two spokes. To do this, use the drill. After the spokes are fixed on the rings (half-rings), which are installed in the rods for adjusting the distance. The number of rings can be anything depending on the nature of the fracture.
The surgery to install the Ilizarov apparatus when the elongation of the limbs is carried out in several stages. After overlay construction, the patient cut through the bone fragments and fix the machine. A week after this procedure you can begin the distraction process. Regardless of the reason for using the design of the tension spokes requires daily adjustment, and the condition of the patient is a strict control.
Compression-distraction device requires special care, as it passes through the bone and can cause infection, to provoke suppurative inflammation. The spokes need time disinfected using a special solution or 50% alcohol with water you want to distill. For treatment should wet the cloth in the liquid and wipe down all exposed areas of the spokes. One wipe is recommended to use not more than two days, then it will have to be replaced.
Treatment by Ilizarov
The main advantage of this methodology is the preservation of a certain degree of functionality of related joints and muscles. Due to this particular treatment of fractures by Ilizarov accelerates the regeneration of bone tissue for rapid fusion of bone fractures of any kind
- complicated by purulent infection.
Ilizarov frame on his leg
Compression-distraction apparatus is used for compression or stretching of the lower extremities. Ilizarov frame on his leg helps to avoid divergence of the edges of the bones after fractures, fixing them in position. In orthopedics, this technique is used to eliminate bone defects, for example, for the adjustment of shortening one of the limbs. In aesthetic medicine machine cycle if necessary, lengthen the leg.
The Ilizarov apparatus on the hand
When the upper limb occurs the complex shape of fracture, fusion using the Ilizarov apparatus on hand. This medical procedure is used when need to adjust the length and shape of the limb when the defect development. On the forearm the device is installed in the fractures, which significantly shifted the radius and ulna.
Corrective hip surgery can be in different ways:
- with the help of plates;
- according to the method of Ilizarov;
- with the use of intramedullary pins.
Ilizarov hip is sometimes used, but wearing it can create further problems:
- contractures and subluxations of the knee joint;
- obvious imbalances;
- severe scarring.
The Ilizarov apparatus on the tibia
In some cases of complex fractures of the tibia is impossible patchwork of fragments of bones, if you create a regular immobilization casts. The Ilizarov apparatus on the tibia is often used in the treatment of patients after car accidents and other situations in which injuries were received from a strong blow or a fall from a height. Multiple fragments are characteristic for injuries this kind are not capable of independent repositioning in the plaster. When using the Ilizarov method, the healing process is accelerated, reducing the period of rehabilitation.
How much are the Ilizarov apparatus
The complexity of the correction, which exposed the bone, determines how much time are the Ilizarov apparatus. In most cases you want to create a compression or distraction of not less than two months. For complex fractures, for example, on the lower leg may take from 4 to 10 months. When is surgical intervention for limb-lengthening or deformity correction, spokes are from 6 months. Individual regeneration of bone tissue also affects the period over which it will be possible to remove the fixture.
How to walk with Ilizarov frame
The period of use of the apparatus is long, but the patient should not abandon all life. Walking with Ilizarov apparatus is allowed and even necessary. Device you can hide under wide clothes that are easy to remove and wear. If necessary, the fixing of the device on the leg can wear wide-leg pants that will hide the installed system and make it invisible in life and even in the photo.
In the treatment according to Ilizarov bone should be given a moderate load after 1-2 weeks. However, the patient can develop inflammatory processes in soft tissues. When complications arise in the form of increasing pain, swelling, redness in the overlap areas, the apparatus used compresses of Dimexidum solution and distilled water. Can also be treated with antibiotics, for example, the drug doxycycline hydrochloride tablets. In a few days if complications persist, you should seek medical help.
To reduce the likelihood of complications due to dust, okazyvayasj on the spokes, maybe a special case. To sew it, use a breathable fabric. The case is a cylinder with rubber bands, which covers the limb above and below. This case is ideal if compression or distraction of correction, which uses the Ilizarov method.
The price of Ilizarov
Compression-distraction devices are different, so to say exactly how much the Ilizarov (region – Moscow) will be difficult. The trauma surgeon will determine the necessary configuration and complexity of the devices, which will depend on the final cost of products. The price affects the place for the treatment which is designed for the kit, material, equipment, other features. Average cost:
- only set – 20-40 thousand rubles, could reach 600 million (depending on complexity);
- operations (cost of machine included) – about 150 thousand rubles (on both legs – 200 thousand);
- doctor’s advice – 3-7 thousand rubles;
- removing structures – 3-5 thousand rubles;
- topogram (x-ray full height) – 5 thousand.
How to remove the Ilizarov apparatus
If you put the device on the limb should be under anesthesia, the removal of the Ilizarov frame is performed often without anesthesia. In places where the spokes were introduced, remain a point of sores. They superimpose bandage with Dimexidum, or other disinfectant. If the bone is not strong enough, the doctors may impose locking splints. Rehabilitation measures after the removal include:
- physical therapy;
- exercises to restore mobility.
Time begun gymnastics and massage will help to restore blood flow, nutrition, and mobility of the limb. The duration of rehabilitation is a doctor. The wound after removing the spokes are handled disinfecting agents to complete their healing. A doctor can prescribe ointments and creams against the resulting edema.
Video: How to put the Ilizarov apparatus
Maria, 22 years
My diagnosis – congenital shortening of the left leg. The difference is 5 cm let live. When the doctor asked me to rectify the situation according to the Ilizarov method, I agreed. The result was a long. It was painful, difficult, but 13 months later I can walk without crutches and spoke on two identical legs. The power of the spirit and good pain medication helped me to cope with the problem.
Anna, 34 years
O-shaped curvature of the legs and low growth has caused a lot of complexes I, so I decided on surgery. The unit I was put on 6 months. During that time I grew 3 cm and the legs are smooth. Went to work in slacks, no one knew that I spoke. Just a little bit limped. Looking at old photos, I think, why have not done this before?
Sergey, 26 years
After a car accident received a comminuted fracture of the tibia. The first month I was put on traction, but it didn’t help. The result is a set of spokes. Still go with the device. Severe pain, swelling or other changes. Load the leg is not strong, yet afraid, take the vitamins and calcium. Doctors talk about a speedy recovery.