A page of assorted orthopaedic things

Whilst building this site, I've come across all sorts of fixation, distraction and osteogenesis info that it seems a shame to waste. So this page will hold some (if not all) of these 'interesting' snippets.

Sequoia ring fixator 1988, Sheffield

The Sequoia Ring Fixator.

Back in 1988, in Sheffield, England, the hospital was using a circular fixator, very similar to the Ilizarov.This was called the Sequoia Ring Fixator. And here we have two photographs of the thing attached to somebody's lower leg.
Although the photograph is not very clear, it would appear that each wire has some form of micrometer-like tensioner attached to one end of it. I wonder if anyone out there has had one and can clarify what these large, metal lumps on each wire actually were.

images/ Sequoia ring fixator 1988, Sheffield

Facial orthogenesis equipment

Facial Orthogenesis

The techniques of bone growth (orthogenesis) by distraction (stretching) is not limited to the long bones of the body ie; the arms and legs.
Indeed as can (just about) be seen from the picture opposite, devices exist for the repair and regrowth of the bones of the face and skull. This is used by Maxillofacial (referring to the upper jaw bone and surrounding areas) surgery to repair damaged facial bone. In fact the 2nd International conference on Cranial and Facial Bone distraction processes using such devices took place in Paris, France on June 17th to 19th 1999.

It works for animals too!

The Ilizarov technique is not just for us two-legged creatures. [I have personally seen a monolateral fixator fitted to a 9 month old Lurcher puppy]. As can be seen from this great picture of a girl and her dog, animals can benefit from the Ilizarov techniques as well. This lovely picture came from the web site of the Kurgan Institute, where it all began.
You can visit that site by going to my LINKS page and clicking the link required.
My acknowledgement to the Kurgan Institute, Russia for the use of their photograph.

A girl and her boxer dog wearing a femoral frame!

A thing of Beauty is a joy forever

Well I don't really know if I'd call an Ilizarov frame a thing of beauty but, with the right back ground and some careful lighting, I suppose it doesn't look too bad!
Thanks to Weno Caestecker for letting me lift this shot from his pages. (Check out his site from the LINKS page.

Art for art's sake!

More maxillo-facial orthogenesis examples.

The picture to the left below shows an example of a distraction device for use within facial orthogenesis
The pictures to the right below show x-rays of before & after the use of a facial distractor to correct a deformity. The lower pictures actually showing the device in place.

Jaw distraction device

Before & after x-rays and fitting of facial distraction device

 

The Ilizarov, it's bits, tools and versions

A selection of the bits and pieces that make an Ilizarov

A selection of the special tools used to assemble & fix an Ilizarov

Tibia and foot Ilizarov

Tibial spatial Ilizarov fixator

Pseudoarthroses Fixator system

A demonstration fixator system being attached to an artificial bone.

Demonstration of frame fitting

Another example of Canine broken bone fixation.

Healing broken bones

Russian technique makes its way to the U.S.

 

Jessica Thomas
Kansas State Collegian

 

 

The discovery of a new treatment for broken limbs may elicit a sigh of relief from patients who are waiting to heal.

In this case, the patients are animals, and the sigh of relief is coming from a canine.

All the excitement is about a new method of repairing injured limbs that recently was applied to a patient at the College of Veterinary Medicine for the first time at K-State.

The Ilizarov method, which utilizes external fixation rather than subcutaneous, or under-the-skin, fixation, was introduced to the United States only recently, but has been practiced in Europe since the '40s or '50s, said Christina Gerdes, fourth-year student in veterinary medicine.

The patient is Jesse Nielsen, a 3-year-old Australian shepherd mix from Nebraska. Jesse was hit by a car, which resulted in fractured bones in the thoracic limb of her right front leg. Her left front leg was paralyzed, so she needed the other leg to heal in order to walk. Jesse's veterinarian referred her owner to K-State because of the college's reputation of having excellent orthopedic surgery care.

Jesse and her canine Ilizarov

Gerdes said the Ilizarov method utilizes special wires through the bone that are attached to a circle fixator that encompasses the leg. This allows for more support and stability, which is just what Jesse needed.

Dr. James Roush, veterinary orthopedic surgeon, said the procedure is named after the Russian doctor who pioneered it. Roush said that according to one story, an Italian surgeon in the '70s or '80s broke his leg while skiing, and the break hadn't healed. After several failed attempts to fix it, the man visited a doctor in Russia. The procedure worked, and the Italian doctor spread the news to other European countries.

Roush said the United States' unfamiliarity with the procedure is most likely due to the lack of information coming out of the Soviet Union during the Cold War.

In the United States, the procedure has been used with growth problems on children such as scoliosis, or curvature of the spine, and to help with angular limb deformities.

"The advantage this procedure is that we can get a grip on small segments of bone that were difficult to grip with other appliances," Roush said.

The procedure on Jesse took about three hours, but Roush said it won't take as long when they start using this method more often.

The Ilizarov method won't be used to treat every limb injury, but in Jesse's case, it was the only solution. Gerdes said the break was so far down on her leg that it was not amendable to regular methods.

While this procedure requires different expertise than the regular methods, Roush said that it is not necessarily more expensive and requires about the same amount of time to heal, which he estimated at about 8-12 weeks.

Jesse is doing well, Gerdes said, and will be discharged this morning.


This item was published on Thursday, February 18, 1999


Copyright 1999, Student Publications Inc. All rights reserved.
This document may be distributed electronically, provided it is distributed in its entirety and includes this notice. However, it cannot be reprinted without the express written permission of Student Publications Inc., Kansas State University.

The following article was e-mailed to me by Barbara and Art Coury. The program was apparently aired by the Australian Broadcasting Corporation. Needless to say, my approaches to the producers, the BBC, in the UK have so far proved fruitless. If anyone has more info or, better still, a copy of the programme on video, I would love to hear from you.
Thanks. Slim Haines

Baby In a Frame

 


At six months old, William Knight is doing his best to stand. But it will take him a little longer than other children and he may never be able to walk without a limp. William was born with a club foot - the most common deformity at birth. Determined that his development will not be held back, his parents, Alan and Madeleine, have volunteered him for a revolutionary new form of treatment, never before tried on such a young child. Baby In A Frame follows his progress.

During a 90-minute operation, wires are pushed through William's leg and foot to hold them rigidly in a metal frame. The frame must stay on for nine weeks. Four times a day for two months, his mother takes a spanner to adjust the frame so that William's tiny foot is gradually pulled back into shape.

Baby In A Frame also takes you to the world's largest orthopaedic hospital in Siberia, where the frame was invented in 1951. Gavril Ilizarov, a young surgeon on his first posting, wanted to offer something more than amputation to soldiers injured after World War II. He was determined to find a way to mend badly broken bones and his frame made with bicycle spokes worked where conventional treatments had failed. Miraculously, it seemed that patients started to grow new bone.

More than 40 years later, Ilizarov's technique is begining to revolutionise orthopaedic surgery in the West. William Knight's doctors, Robert Simonis and Rowan Poole, visit the hospital in Siberia which has treated 30,000 patients with the Ilizarov frame. They have 25 years of research to draw on and are now opening their doors to the West.

Back in England, it's time for William's frame to be removed. "I've never had any doubts," says Madeleine. "You could see it working every day, and his foot coming into a normal position. Mr Poole told me when he was three days old he'd get him walking, and I believed him." Six weeks later, at William's first birthday party, the frame is off and we watch as, squealing with delight, the toddler takes his first faltering steps.

Producer: Fiona Holmes
Narrator: Ian Watson

A BBC production.

On Air: Thursday 8 May, 1997 at 8.00pm



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