Radiologic assessment of bones after Ilizarov procedures

Ilizarov procedures, introduced recently in the United States, were performed in 163 patients aged 2-53 years who underwent pure limb lengthening for inherited conditions such as achondroplasia (37 procedures), correction of angular deformity secondary to nonunion or malunion of fractures (62 procedures), or correction of congenital/developmental angular deformities of the limbs (64 procedures). Before surgery, every patient was evaluated with plain radiography; after surgery, every patient was evaluated at weekly or biweekly intervals with standard plain anteroposterior and lateral radiography, with acquisition of additional radiographs centered over the distraction site. Every patient had complete bone healing, which took 3-14 months. In all patients, new bone formation was evident within 15 weeks after surgery. Complications associated with the Ilizarov technique were minimal (delayed formation in two cases and cyst formation within the distraction site in two cases), but success relies heavily on radiographic evaluation. Radiographs of the whole bone or joint must be obtained for overall assessment of bone alignment; specific views of the distraction site, with the x-ray beam centered over this site, may be required.