In the fast life of today, where there is an incessant race against time and where success is gauged in terms of power and pelf, life affords little to rest and motion has become the hallmark of a successful person.

Patient who either sustain long bone fractures or undergo orthopedic procedure are often disabled for many month or even years. They may experience delay in osseous consolidation. Conventional methods of promoting bone union frequently do not work. Indeed, some techniques can cause serious pathologic changes. To make matters worse, protracted delay in healing compromise the function of the limb, thereby disabling the patient permanently.

The most frequently cited causes of disability in cases of long bone fractures include delayed consolidation, nonunion, malunion and joint contracture. For this reason, any technique that reduces both temporary and permanent disability following an injury should assume treat socio-economic importance, since trauma victims are frequently unproductive during convalescence.

In india number of patients affected by diseases like poliomyilitis, chronic osteomyelitis, tuberculosis, malnutrition which cause deformity and limb length discrepancy is increasing very steeply. It is estimated that there are about 10 million orthopaedically handicapped children and adults alike having deformities in their limbs, be it a deformity by birth like polio etc. or any other deformity caused at a later stage because of an accident or for any other reason. For such people Ilizarov method of treatment is the only answer where all other treatments fail to cure. It is said that Ilizarov method of treatment can cure up to eight hundred different types of bone deformities.

LIMB lengthening and deformity correction is a revolutionary concept developed by Dr. G.A Ilizarov, reversing the long-held belief that bone could not be regenerated. With this process, a bone that has been cut during surgery is gradually pulled apart, leading to new bone formation at the site of the lengthening. In this way, bone segments can be lengthened by 15 to 100 per cent of their original length. This method, known as Ilizarov operation, offers much better results than conventional orthopaedic surgical techniques.In fact, Ilizarov operation is not one operation, but a method, where an external fixator is used to treat many different conditions. A customised apparatus is pre-constructed by the surgeon in preparation for each surgery. Using wires or pins, the apparatus is surgically attached to the affected limb.

One of the most useful application of Ilizarov method is, treatment of nonunions. in Ilizarov method no bone grafting is needed while by conventional methods of tratment bone grafting is must which leads to other incision, more blood, more pain, more bed rest etc. Today it is necessary, as it is in other treatment modalities, for the modern life style that the postoperative follow up period of the limb legthening is comfortable and that the hospitalization time is short. The advantage of this technique is that patients can start functioning very early. It is said that Ilizarov method of treatment can cure up to eight hundred different types of bone deformities. A few of them are listed below:

• Achondroplasia i,e. low stature (lengthening of tibias, femurs, humeri)
• Ankyloses of major joints in malposition.
• Congenital and acquired foot deformities (club-foot, equino-varus and equinus, pescalcaneous etc.)
• Congenital and acquired limb shortening (lengthening of femur, tibia, humerus and forearm)
• Congenital and acquired long bone pseudoathroses, including infected ones.
• Congenital finger shortenings and stumps, developmental hand abnormalities, syndactyly.
• Congenital and pathological hip joint dislocation.
• Contractures of knee and elbow joints.
• Foot stumps / Arm Stumps (lengthening for proper prosthetic fitting)
• Height problems (height increase/decrease)
• Long bone defects, including infected ones.
• Non-united and malunited fractures.
• Thromboangitis Obliterance.
• Open and closed fractures of any localization.
• Pelvic pathologies and injuries.
• Poliomyelitis sequelae (lengthening, thickening and fine shaping of shin and foot)
• Tibial stump (lengthening, formation of a foot-like support)
• Valgus and various limb deformities, including the ones with shortening.

• Limb Lengthening
• Deformity Correction
• Malunions
• Osteoarthritis of knee joint
• Complex Fractures
• Congenital pseudarthrosis of tibia
• Clubfoot
• Poliomyelitis
• Reconstruction of Hip
• Vascular Disease (TAO)

Ans. Bone lengthening is procedure done on the affected bone/limb to increase the length of the bone. It is done on patients whose limbs are shortened or deformed either due to some accident, trauma or by birth. A small difference in the leg lengths can have a significant functional effect on the patient, whereas a large difference (greater than 7 cm) in arm is necessary to cause a problem. this difference in the length of the limb is called LLD or Limb Length Discrepancy.

Ans. Long term effects of LLD are not very well documented. Some clinical problems caused by Leg Length Discrepancy are as follows

* Foot Calluses.
* Increased energy consumption in walking, causing fatigue.
* Cosmetically unappealing limp.
* Low back pain.
* Scoliosis.
* Degenerative arthritis of the lumbar and sacroiliac joints.

Ans. Patients with discrepancy of less than 1 inch should avoid bone lengthening and go in for other alternatives. Bone lengthening is appropriate for discrepancies between 1 inch (205 cm) and 18 inches (45 cm). These figures are highly individual and depend from patient to patient.

Ans. A wide variety of treatment options exist for the patients with limb discrepancy and the simplest form of treatment does not requires surgery. Shoe Lift – A sole or a heel can be attached to or inserted inside the shoe and can effectively level a difference of one to five centimeter. Beyond this, the lift gets heavy, awkward and can cause problems such as ankle sprains and fall. Shortening the longer side – On the surface, this may sound illogical and even dangerous, but bone shortening can be simple, safe and effective way of equalizing leg length.. Limb shortening can be accomplished in one of two ways :
1- The growth plates van be arrested prematurely by epiphyseodesis.
2- The long bone can be shortened by resenting a segment of the bone.

Ans. Congenital limb deficiency is a term used for a condition, present at birth, that results in shortening, deformity or dysfunction of the limb. There is commonly present additional deformities or deficiencies of the surrounding tendons, muscles and joints.

Ans. Growth plates are disc shaped areas of a specialized cartilage located near the ends of the bone in the growing child. When we stop stop growing taller (in girls it is about 14 & years of age and in boys is 16) the growth plate seal with bone and cease to add length to the bone. A fracture which occurs through the growth plate may cause it to fuse prematurely, resulting in limb length discrepancy. The younger the child at the time of injury, the greater the shortening that may result.

Ans. Limb lengthening duration is variable and dependent on many factors. It includes the degree of deformity to be corrected, physical health, age of the patient. In younger children the growth rate may be surprisingly excellent where as in adults it is slow. For a normal limb lengthening the distraction rate is One mm per day and it takes two to three times for actual maturation.

Ans. The simple answer is it depends on the tolerance of the patient.

Ans. Chandak Hospital located in Gwalior , a very important city of India, it provides excellent medical facilities at very affordable rates .Free consultation is given to the needy and poor patients. The same kind of llizarov treatment available in United States, Singapore, Russia, Bombay, Delhi would cost up to three to five times more than in Chandak Hospital Gwalior, With the same world class facilities and excellent patient care Chandak Hospital has been drawing patients from all around the country.

Ans. The patients stay at the hospital is surprisingly brief. The patient is explained the lengthening procedure which is very simple and he can follow the protocol at his home only. Further the patient is encouraged to walk with full weight bearing next day after surgery.