Dr. Mangal Parihar 

- Discussion: The rhythm and more so the rate of distraction are not fixed numbers. 1 mm per day in four equal fractions is only the recommended average. There are frequently cases that require a slower rate, or occasionally a faster rate. This can only be adjusted if one is looking closely at and monitoring the quality of regenerate at the distraction gap. The distraction gap should show shadowy streaks of linear ossification by the end of three weeks. This ossification should show progressive improvement over subsequent x-ray examinations. To be able to compare the opacity of the gap from one examination to the next, one must ensure the same exposure factors are used. In cases with more than one corticotomy, each corticotomy should be evaluated with an x-ray centered on that particular corticotomy. A regenerate with a transverse diameter larger than the diameter of the parent bone could be very likely due to instability in the frame, rather than increased bone formation; and the rate of distraction should be increased in such cases only after a careful examination has ruled out instability. 

- Ilizarov Post Op Care 
- Menu: 
- The Early Post-op period (the Latent Phase) 
Pain relief 
- Limb Positioning
- The Distraction Phase 
- Neurological Examination 
- Pinsites for Signs of Inflammation / Infection 
- Stability of Frame & Components 
- Ambulation 
 Follow-up Checklist (X-rays) 
- Quality of regenerate.   
Physiotherapy 
- The Consolidation Phase 
Removal of the Fixator and Post Fixator Removal