Ilizarov External fixator in orthopedic

1. Ilizarov external fixator
Dr. Mohamed Iraqi Gadalla
Consultant Orthopedic Surgery
Al Dar Hospital
Master Degree Orthopedic.
Egyptian Board Orthopedic.
Arab Board Orthopedic.

2. The Ilizarov apparatus is a type of
external fixation used in
orthopedic surgery to lengthen or
reshape limb bones; as a limb-
sparing technique to treat complex
and/or open bone fractures; and in
cases of infected nonunions of
bones that are not amenable with
other techniques. It is named after
the orthopedic surgeon Gavriil
Abramovich Ilizarov from the

4. Ilizarov used external fixation
devices on patients to treat
non-unions in the 1950s.[1]
Ilizarov observed the callus
formation and discovered
distraction osteogenesis
when one patient lengthened
his frame rather than
compressing it.[1] The
procedure, and the first
apparatus he designed for it,
was inspired by a shaft bow
harness on a horse carriage

6. Ilizarov gained more fame in 1980
when he successfully treated Italian
journalist and adventurer, Carlo
Mauri.[1][3] Mauri had broken his
leg in a skiing accident ten years
earlier and his tibia never properly
healed.[1] When he was on an
expedition across the Atlantic, the
wound on his leg reopened and a
Russian doctor advised him to see
Ilizarov.[1][3] When Mauri returned
to Italy after his treatment, Italian
doctors were impressed that his

10. Ilizarov`s concept for infected nonunion:
Osteomylitis burns in the fire of regeneration
Activate biosynthetic process, increasing local
resistant to infection

11. Three ways of elimination of infection in
Ilizarov method
Controlled osteogenesis, filling of cavities by newly
formed tissue
Resection of infected bone and subsequent intercalary
bone lengthening
Gradual bone transport of one wall of the cavity

12. Ilizarov
Distraction osteogenesis
Tension-stress effect
Mechanical induction of new bone formation
Neovascularization
Stimulation of biosynthetic activity
Activation and recruitment of osteoprogenitor cells
Intramembranous ossification

15. Monofocal method

16. Bifocal
method

18. Bilocal simultaneous compression-
distraction osteosynthesis
Small gap & substantial bone shortening

19. Bilocal consecutive distraction-
compression osteosynthesis
Large gap

21. Virtual hinge
“global positioning”
Defined point
Relative to the
Reference ring

22. Can the Ilizarov method be used
to treat bone and soft-tissue
defects simultaneously without
the use of flap coverage?

25. Taylor Spatial Frame

26. Limb Lengthening

27. Conclusion
Ilizarov is a golden method for the management of
nonunion osteomylitis for both achieving union and
eradication of infection, however generous, careful
sequential debridement and hardware/dead tissue
removal and bone grafting is also an option for some
selected cases.