Ilizarov G A
Kurgan All-Union Center for Restorative Traumatology and Orthopaedics, USSR.
Clin Orthop Relat Res. 1990 Jan(250):8-26.
For 40 years, the author has been developing a system of orthopedics, traumatology, and limb lengthening using a circular transfixion-wire external skeletal fixator, often in combination with biomechanic methods of stimulating the formation of new osseous tissue within a widening osteotomy distraction site. The factors important for neoosteogenesis after osteotomy include: maximum preservation of extraosseous and medullary blood supply; stable external fixation; a delay prior to distraction; a distraction rate of 1 mm per day in frequent small steps; a period of stable neutral fixation after lengthening; and physiologic use of the elongating limb. For a successful fixator application, the apparatus must be applied with consideration given to the number, size, and location of the rings, the placement and tension on the wires, the technique of wire insertion, the effect of soft-tissue transfixion on limb use, and the prevention of bone and joint deformities caused by countertension in soft tissues. Clinical application of the author's techniques permits stature increase in certain forms of dwarfism, correction of deformities and limb-length inequalities, and stump elongation. For many of these applications, motorized distraction can provide continuous limb lengthening while the apparatus is on the patient.
40年来，作者一直在开发一种骨科、创伤科和肢体延长系统，使用环形穿针外骨骼固定器，通常结合生物力学方法，以刺激在逐渐扩大的截骨牵张部位形成新的骨组织。截骨术后对新骨形成重要的因素包括：最大限度地保留骨外和骨髓血液供应；稳定的外固定；牵张前的延迟；每天1毫米的牵张速度，分多次小步进行；延长后稳定的中立固定期；以及对延长肢体的生理性使用。为了成功应用固定器，必须考虑环的数量、大小和位置、钢丝的放置和张力、钢丝插入技术、软组织穿针对肢体使用的影响，以及防止软组织反张力导致的骨和关节畸形来应用该装置。作者技术的临床应用可使某些类型的侏儒症患者身高增加，矫正畸形和肢体长度不等，并延长残端。对于许多这些应用，电动牵张可在装置安装在患者身上时实现肢体的持续延长。
