The Severely Traumatized Lower Limb

---

Symposium: Local Bone Transportation for Treatment of Intercalary Defects by the Ilizarov Technique: Biomechanical and Clinical Considerations. Aronson-James. Johnson-Eric. Harp-John-H. Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Department of Orthopaedics, University of California at Los Angeles Medical Center, Los Angeles, California. Clinical Orthopaedics and Related Research. 1989 Jun. 243. pp 71-79. Ilizarov applied revolutionary methods for salvaging limbs with severe congenital, posttraumatic, or other acquired deformities. His methods, which use a universal system of ring external fixators with tensioned transosseous wires, were developed over the past 35 years at his institute in Kurgan, USSR. These noninvasive techniques have proved successful in over 300,000 patients (adults and children) treated for bone shortening and intercalary deficiency, angulatory and rotational malalignment, active infection, ischemia, joint contractures, and nonunions. Bone transportation involves moving a free segment of living bone to fill intercalary bone defects with vital bone. The trailing end of the transport bone segment maintains continuity with the host bone surface by distraction osteogenesis. The leading end of the transport bone segment fuses to the target bone surface by transformational osteogenesis. The small diameter of the transosseous wires contributes to better patient tolerance over the prolonged treatment times required for gradual distraction at 1 mm0 per day.