Ilizarov's device was created in the early fifties of the XX century by the famous Soviet surgeon G. A. Ilizarov. The device manufactured by Ilizarov consists of four metal spokes of skeletal traction fixed on two rings and connected among themselves by mobile bars. For many years this device was gradually improved. The modern device of Ilizarov is manufactured of titanium with a high rate of durability. In a modern design instead of spokes titanic or carbon fiber cores are used. Rigid rings in it are replaced with plates, полукружья and triangles. The modern medical device, rather easy and small by the sizes, is widely used in traumatology, in esthetic medicine and orthopedics for correction of proportions of a body, curvature of legs, inborn deformations, a clubfoot, anomalies of development of bones of foot. This device is used at rickets, a pseudoarthrosis, at changes of various localization and complexity, and also to increase in growth at system diseases of a skeleton, to treatment of a contracture of joints, to elimination of defects of the soft tissues and bones which arose after tumors, infections or injuries.
Compression дистракционный Ilizarov's device is intended for distraction (extension) or a compression (tightening), and also for long fixing of separate fragments of a bone. At any change of edge of a bone can be displaced as muscles pull them in the different direction. Use of the device of Ilizarov on a leg or a hand at a change interferes with the shift of bone fragments. He reliably fixes not accrete changes and nearthroses and does not demand use of an additional plaster immobilization. Along with therapy of nearthroses and not accrete changes the device with success is used to correction of length of an extremity.
Process of installation of the device of Ilizarov on a leg or a hand at a change happens as follows. Through each fragment of a bone in the field of a change carry out by a drill two spokes, crossing them at right angle. Couple of spokes of each bone fragment is fixed and fixed in a ring (half ring) by means of a special key. At a podkruchivaniye of nuts on mobile bars the distance between rings changes. Rapprochement of rings provides a compression between edges of fragments. Because of deformation of spokes compression force gradually decreases. Therefore the tension of spokes needs to be controlled and regulated daily. Skillfully manipulating mobile bars, it is possible to eliminate the shift of fragments on axes, angular deformations, and also to make the closed reposition of bone fragments.
Lengthening of legs Ilizarov's device is carried out step by step. At first to the patient impose the device, then make a section of a bone (osteometriya) and fix fragments by means of an orthosis. Gradual lengthening of legs (distraction) is begun approximately in a week after operation. Speed of lengthening of extremities makes one millimeter a day. Speed of distraction depends on individual portability the patient given procedures. So, distraction duration when lengthening extremities on five centimeters makes from 50 to 75 days. The period of fixing begins after the end of the period of lengthening of legs. Usually the period of fixing lasts twice longer than the distraction period.
Approximately in a month the second extremity operation is performed. Operations on lengthening of extremities are performed under anesthetic. The patient can go by means of crutches already to second day. During rehabilitation the patient is recommended to float and go.
Ilizarov's device is used also for elimination of curvature of extremities. During operation the bone is cut on the site of its deformation, and then fixed in the correct situation by means of the device. Installation of the device of Ilizarov consists in carrying out spokes through bones and introduction of cores. Correction of a shape of legs can be as gradual (deformation is eliminated at daily correction), and single-step (correction is carried out directly to operation time). Daily correction is made by the patient. The device is removed after bones grew together in the correct situation. Modern devices of Ilizarov; have rather small sizes therefore the patient can move fully practically right after operation.
Installation of the device of Ilizarov allows to reduce terms of merging of a change and to reduce probability of development of a nearthrosis practically to zero. Partial load of the injured extremity is possible for the second or third day after the procedure.
Nevertheless, this device has also shortcomings. Rings quite often prevent to sit and lie normally. In places of a puncture after removal of the device there are dot scars. In some reviews of Ilizarov's device it is said that at his use many patients have hypostases and the aching pain preventing to sleep.
Only the specialist can remove the device. As tell responses, most often remove Ilizarov's device without preliminary anesthesia.
After removal of the device of Ilizarov on the injured extremity there are small wounds which quickly enough begin to live. For acceleration of healing it is possible to process wounds the disinfecting drugs. Over time on places of the removed device there are almost imperceptible hems.
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