ILIZAROV  METHOD  MENAGGIO

Gavril Abramovich Ilizarov, orthopaedic surgeon, the 9 june of 1952 patented a ring external fixator with peculiar characteristic for fracture treatment . Although similar frames had been, outside the knowledge of Ilizarov, proposed before ( Bittner 1932, Wittmoser 1950), their clinical use never reached significance. Conversely Ilizarov, sensing the potential of the apparatus, applied it on many patients treating fractures, bone deformities and correcting  various forms of dwarfism.

Circular structure of the fixator consented to transfix the bone along safe corridors with steel wires and to tension them on the frame, increasing fixator strenght  and tissue tolerance. 

Multi-planar stability of Ilizarov apparatus , elastic modulus of tensioned wires, potential correction of misalignments through olive wires or hinges, make this ring fixator excellent in dealing with long bone fractures. Ilizarov method preserve the biology of  facture site, and can modulate mechanical loads at the fracture level in a way no other method of osteosynthesis can do. 

Furthermore, threatened bars that connect rings consent to approach or outdistance rings at controlled speed, placing compression or distraction on bone.

Interrupting the cortical bone Ilizarov, after a latency phase, distracted bone at a daily speed of 1 mm ( 0.25 mm four times a day) and obtained a bone regeneration. This consents lenghtening in dwarfisms and post traumatic shortenings with leg lenght discrepancies.

Ilizarov ideated a technique, the bone transport, to treat complicated forms of non unions. This technique consists in a large resection of the non vital or infected bone, followed by a transfer of a bone segment on which basis a corticotomy ( transection of the bone cortex) was distracted to regenerate new bone. The transported bone fills progressively the defect.

For decades applied only in Russia   Ilizarov method  was studied in  the seventies by italian orthopaedist Monticelli and Spinelli, but only in the eighty the Lecco orthopaedic surgeons prof. Roberto Cattaneo, dr Angelo Villa, dr Maurizio Catagni applied it extensively on patients and promoted the technique in the United States of America and worldwide.

Actually Ilizarov method is considered as the golden standard in treating non unions with large bone defects, and it  is employed widely for bone lenghtenings and angular corrections.

The introduction of hexapod octosaedric bars ( Gough, Stewart and Cappel platform) with digital control has in some instances ameliorate management and accuracy of the Ilizarov method.