Ilizarovs Limb lengthening procedure in a complicated post traumatic shortened limb- A rare case report

Ilizarov's transosseous wire with circular external fixator is nowadays the most successful method to achieve limb lengthening, due to various causes in a shortened limb segment. A 19 year old male patient with 14cm of lower limb shortening on the right side confined to the leg segment, following a motor vehicle collision 12 years before. He had open fracture of both bones right leg with significant bone loss. Patient underwent many conventional procedures for tibial nonunion, infection and skin loss and finally resorted with leg segment shortening of 14cm, with fibrosis of the soft tissues, anterior angulation of distal part of right leg and ankylosed ankle fixed in equinous position. Patient strongly requested and gave willingness for only limb lengthening without correction of any deformity so that he can use the right limb to touch the ground while walking. Ilizarov's method was planned for this patient to lengthen 10cm of the affected limb, because the remaining 4cm is compensated by the ankylosed ankle fixed in equinous position. Ilizarov's limb lengthening procedure with controlled distraction osteogenesis was done and now with 2 years follow up, lengthening of 10cm achieved with correction of anterior angulation deformity and good stock of regenerate and patient walking with full weight bearing using newly lengthened limb. This case is presented because of the rarity of successful lengthening technique in a poor quality bone with long segment shortening. This article also provides an overview of principles, application, advantages and complications of Ilizarovs method.