After full examination and consultation with the patient and his family, a treatment plan is designed. The patient is kept fully informed about each step of the treatment and its duration, which varies according to the complexity of the procedure.

Hospitalization is usually the day of surgery or one day prior to it. With the use of wires or pins, the apparatus is surgically attached to the affected limb. Surgery usually requires one or two small incisions, with special care to minimize injury to the bone and the surrounding soft tissue. Transfusions are not required, as blood loss is usually minimal. Anesthesia may be local, spinal or general, depending on the type of the procedure and the patient’s age. Usually, patients are discharged 2 - 7 days after the surgery to continue treatment as outpatients. A more complex procedure may require a longer inpatient stay.

One of the most important principles of the Ilizarov technique is to maintain and increase physical activity during the treatment.

Rehabilitation, including physical and occupational therapy sessions, begins the day after the surgery when the patient stands up, puts weight on the treated limb and walks. Crucial for maintaining joint flexibility and healing the bone and soft tissue, this also has a dramatically positive effect on the patient’s mood and outlook. This is especially important for patients who have suffered from untreated orthopedic disabilities for many years and may have become affected emotionally and psychologically. All patients are encouraged to resume their normal activities to the fullest extent possible, including returning to work, school, and even some sports. Physical therapy at the center includes recreational activities and trips to mineral hot springs for muscle and general relaxation.

Actual manipulation of the limb for lengthening, straightening or healing usually begins approximately 1 week after the surgery. At that time, adjustments are manually made to the external fixator. Bone distraction is conducted at a rate of 1 or 2 mm per day.

The outpatient period can last from 1 to 4 months, depending on the procedure. In some complicated cases, longer outpatient period may be required. During the outpatient period the center’s medical staff monitors the recovery process through visits to the patient’s home and in the center’s outpatient clinic (every 1-2 weeks) for x-rays and frame adjustment and care. Physiotherapy and rehabilitation are constant, and the patient maintains a regular diet and healthy lifestyle throughout the treatment.

After the desired results have been achieved, stiffness of the frame is gradually decreased to slowly transfer weight from the frame to the bone (bone training). Once the new bone is clinically tested, the frame is removed under local or general (small children) anesthesia. The new bone tissue assumes all the qualities and strength of normal bone.