History is witness that some of the inventions have proved to be milestones, which are very useful in the development of different technologies. In this chain the inventions of Gabriel Ilizarov have been proved very important in the treatment of orthopedic problems. Gabriel Ambramoich was born in Poland and was educated in Russia and established Kurgan Research Institute in Russia which is the biggest research Institute for Orthopedics so far. He developed the concept of distraction osteogenesis and Illizarov techniques.

In this technique a bone is cut into two halves and if the distance between the two is increased slowly then there is new bone formation in between the ends which is converted into normal bones within few months. On other side when we compress the bone slowly then non union even with infection, bone get united. For slowly separating two ends of bone thin wires and ring are used, both end of the bone are kept inside rings and are connected to rings via wire. Initially this technique was used in uniting bone nonunion but now this technique is used in various orthopedic problems like bony nonunion, malunion, congenital bony malformation, lengthening of small limbs, increasing height of dwarfs, uniting multiple comminuted fracture, making of bone in absent bones and uniting infected fractures. Besides this it is also used in burger disease in which there is reduced blood circulation in legs. in this techniques all the equipment are outside body . This techniques works on many principles . In first principle it is seen that if a bone is cut at one place and is slowly moved at the speed of 1 mm per day and distance between two bones is increased then there is new bone formation between two bones which becomes like absolutely normal bone. It is also seen when distance between is increased then new blood vessels are formed, which facilitates early reunion of bones and in Burgers disease blood circulation is started. This instrument and principles of Illizarov have been proved very useful in increasing bone and muscles length, correcting limbs deformity, correcting various orthopedic problems and deformities , correcting infected bones and uniting bones nonunion.

After this many improvements have been done in Illizarove technique. First is Hybrid fixator in which thick pin is used in place of thin wires which causes less pain. A rail system is also developed in which thick pin is used in place of wire and straight carbon plate is used in place of
rings. This facilitates movement in patients and reduces problems. these days Ilizarov  principles are improved more and made easier . in more advance manner, rod is put inside bones and is attached to rail system and length between bone ends is increased. When length is completed then outer rail system is removed and the rod between bones is fixed with screw to the bones. In all these type of Illizarov techniques there is no or very less need of incision during operation which reduces bleeding and the patient starts moving very soon.
After operation special care must be taken for the cleanliness of wires , rods and rings, and after operation the patient start taking his weight and start moving very soon. nowadays this system is also supported with computer software which had made treatment of difficult orthopedic problems possible.

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Dr. Jitendra Kumar Jain is a famous name in the field of childhood physical disability pediatric orthopedic problems in North India. He has been an MS Orthopedics, DNB Orthopedics, Pediatric orthopedic surgeon & also a cerebral palsy specialist for over 21 years.

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