News & Updates










Myths about Ilizarov

  Every patient presents a different problem and one needs to summon all the knowledge to do the best for the patient. The surgeon should not get tied down to a methodology and should be prepared to mix and match different techniques to get the best functional and anatomic result.

In the example shown here in the pictures, the patient had multiple deformities in both lower limbs and at different levels. A combination of treatment modalities was used. In the first stage bilateral distal femur corrective osteotomy fixed with intra-medullary nail was done. The residual tibial deformity on right side was corrected gradually with an Ilizarov ring fixator and appropriate hinges and LRS fixator for the left proximal femur.

Some surgeons may argue in favor of correction of all deformities in a single stage using ring fixator or open wedge corrections and internal fixation.
But our aim is to achieve the best functional and anatomic result for the patient with minimal inconvenience to the patient in terms of both educational and vocational.
The final result as shown in the picture on the left. The anatomic result is not the only thing we aim for, the ultimate aim is what we see in the picture on right. A happy and satisfied patient is the success that our team strives for.

The “agony” of Ilizarov patients is a myth which we want to break with the efforts of our team, and that is what I teach other Orthopedic Surgeons that if all the precautions and care is taken ring can become the king again.

Patient Pain

Tips we use to reduce patient's pain:
  1. Use NSAIDs in the pre-operative period. Oral NSAID can be started on the day before the surgery in an elective case otherwise a pre-operative or pre-induction diclofenac rectal suppository helps in reducing the surgical inflammation and hence postoperative pain.

  2. Adequate release of skin tension (green arrow) at the end of surgery to release skin tenting (white arrow), to allow easy movement of skin and soft tissue over the pins while movements, reduces pain and discharge from the pin sites.

  3. Injection of Marcain (long acting local anesthetic) in the incisions and pin sites helps in reducing the immediate post-operative pain.

  4. “Magic Bullet”, that's what we call the diclofenac rectal suppository – Jonac, at the end of surgical procedure (if not used pre-operatively) or at 12 hourly intervals keeps the patient comfortable and largely pain free, at the same time avoiding the gastric irritation that the oral medication may cause.