Devices Used in Limb Lengthening Surgery
The main devices used for carrying out limb-lengthening procedures are known as fixators. They are of two types: external fixators and internal fixators.
Ilizarov made use of an external fixator for the procedures that he performed. He is credited with inventing this type of device.
An external fixator is a device that surgeons attach to the bone using wires and pins to extend and support the limb. It helps to pull apart bone segments mechanically, thus promoting lengthening.
There are different types of external fixators. They include the following:
Ilizarov ring fixator – This device comprises of rings with varying diameters. Surgeons make use of cross K-wires to secure it. Ilizarov ring fixators are effective for gradual limb lengthening or deformity corrections. The main issue is that their use is typically accompanied by significant pain.
Tailor spatial frame – This circular device is a modification of the Ilizarov external fixator. The metal frame features two rings connecting with six telescopic struts. Use of computer software makes these devices perfect for performing complex corrections.
Monolateral fixator – Introduced by Dr. Heinz Wagner in 1978, this kind is used on a side of the bone. Monolateral external fixators are attached to the bone with the aid of conical or tapered half-pins.
Also known as an implantable lengthening nail or intramedullary nail, an internal fixator is a type of rod that surgeons place inside the bone for limb lengthening or deformity corrections.
The first kind to be used by most surgeons in the United States was called the Intramedullary Skeletal Kinetic Distractor (ISKD). But this internal lengthening nail is no longer as popular in the country due to the high incidence of irregular distraction.
PRECICE internal fixators appear to be more preferred by surgeons these days. These devices feature an expandable rod with a magnetic gear system on the inside. An external remote control relying on a magnet is used to lengthen the rod inside the bone.
Some procedures combine both internal and external fixation. For instance, a technique brings together osteotomy, an external fixator, and an intramedullary rod.