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 patients
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
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 patients 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 centers medical staff monitors
the recovery process through visits to the patients
home and in the centers 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.