Current Concepts Review - Limb-Lengthening, Skeletal Reconstruction, and Bone Transport with the Ilizarov Method*

Ilizarov embarked on his remarkable medical career as a general practitioner in the small industrial town of Kurgan, Siberia, after World War II69,75,96. Antibiotics were scarce, and chronic osteomyelitis associated with loss of bone, non-unions, and skeletal deformities were so common that Ilizarov found himself practicing orthopaedics although he had had no formal training in that specialty. With the use of modular-ring external fixators and transosseous wires attached to the rings under tension to stabilize the bone fragments, he introduced the concept of induction of local bone formation with a minimally invasive procedure69,75,96. Ilizarov coined the term distraction osteogenesis to describe the induction of new-bone formation between osseous surfaces that are gradually pulled apart9. His clinical successes in the salvage of limbs that would otherwise have been amputated and in the return of disabled patients to productive levels of activity eventually spread by word of mouth throughout the Communist bloc of countries69,75. By 1981, a group of Italian orthopaedic surgeons had learned of his technique9. More recently, the method was introduced in North America, where it has been adopted primarily for limb-lengthening12,49,120,125 and the correction of limb deformities as well as the treatment of non-unions and bone loss secondary to trauma, infection, or tumor39,41,43,46,76,78,99,114,124,135,142. Ilizarov practiced in an isolated area of the world without access to the many technological and medical advances that took place during the four decades after World War II. As a result, he relied on distraction osteogenesis to treat a variety of musculoskeletal conditions. The reconstruction of …