fixation of ilizarov.

1. ILIZAROV FRAME
ASSEMBLAGE
General considerations
1.Stability of frame fixation to bone.
2.Prevention of bone fragment motion.
3.Ability to manipulate.

2. FRAME CONSTRUCTION
FIRST TYPE
• Advanced Preparation – Time saving but require adjustments.

3. SECOND TYPE
• Construction during surgery.

4. RING POSITION

5. RING LEVEL
• Determines distribution of the forces.

6. SPACE BETWEEN SKIN AND RING
• 3 cm minimum at the narrowest gap.

7. RING POSITIONING AT
OSTEOTOMY/CORTICOTOMY,
NONUNION AND/OR FRACTURE SITES
• Stability of this frame depends on the level and
position of the pusher-puller ring.
• It is placed no closer than 2 cm and no further than
4-5 cm from the tip of the fragment end.
• Bone fragment end structure almost always is
weakened by the microfractures during osteotomy
or fracture, In non union it is weakened by regional
osteoporosis.
• Need for the free-fragment-end structure
preservation in above all conditions.

8. RING ORIENTATION
• Must be aligned for the connection , so half-rings
are situated along the same straight line.

9. WIRES – TYPES AND UTILIZATION
1. General considerations.
2. Technique of k-wire introduction.
3. Wire positioning on same ring.
4. Offset wire positioning.
5. Wires with stoppers.
6. Proper distance of wire from joints.
7. Wire tensioning.
8. Affixing wire to ring.
9. Reducing ( correcting ) wire.
10. Wire re tensioning technique.
11. Wire cutting and bending.
12. Guide wire
13. Pulling / Traction wire
14. Bone fixation with half pin.

10. 1.General considerations
a. K – wire when drilled destroys verylittle
bone,tissue,marrow.
b. If tensioned properly it decrease vibration and
prevent soft tissue, bone destruction by its
elasticity.
c. Small penetration holes, so minimum
contamination.

12. K-WIRE INTRODUCTION TECHNIQUE

14. WIRE POSITIONING ON SAME RING

16. DISTANCE FROM JOINTS,DIRECTION

17. WIRE TENSIONING

18. • The range of the wire tensioning strength is 50 -130 kg.
• General recommendations
1. Wire on half-ring: 50 to 70 kg.
2. Offset (drop) wire, depend on supporting posts: 50 to 80.
3. Single wire on a ring: up to 100 kg.
4. Two to three wires on a ring in a young patient: 110 kg for
each wire.
5. Two to three wires on a ring in an adult patient: 120-130
kg for each wire.
6. Wire with an olive stopper: 100 -110 kg
7. Wires with olive stoppers used for inter fragmentary
compression 50 kg.

19. TENSIONING TECHNIQUE

20. AFFIXING WIRE TO RING

21. REDUCING (CORRECTING) WIRE

22. WIRE RETENSIONING TECHNIQUE
• In the long course of treatment, some of the
wires will become slack as a result of metal
fatigue and enlargement of the holes in the
bone
• Slack wire produces pain, and inflammation
• Low-pitched tone when the wire is tapped
confirms weakened tension and loss of stiffness.
• Re tensioning is performed by applying two
wrenches simultaneously to the head of a
fixation bolt and a nut and slowly turning both of
them a quarter-turn or half turn

23. WIRE CUTTING AND BENDING

24. GUIDE WIRE
• Prevent 2 level distraction and fragment
deviation.
• Provide axial stability.

25. PULLING OR TRACTION WIRE
• Connect between movable fragment and
traction mechanism.

26. BONE FIXATION WITH HALFPINS
90
DEGREE
ARCH
120
DEGREE
ARCH