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Post Op Care in the Ilizarov Method

by Dr. Mangal Parihar 

- Background:
In conventional orthopedic surgery, the manipulation of bones or other tissue is done only during the actual operative procedure, usually there is no active manipulation of the tissues during the post-op period. In contrast, with Ilizarov surgery, the manipulation of the tissues really begins only a few days after the actual surgical procedure. Looked at in this way, it becomes easy to understand, why the post-op period is so important in the Ilizarov Method. It is really a temporal extension of the surgical procedure and therefore needs the same high level of care and monitoring that we apply during the actual surgery. One could go as far as to say that the post-op period is probably more important than the time spent in the operation theater. It is a well known fact that the Ilizarov method is not without complications. Most of these can be prevented by diligent post-op care, and those that do occur can be treated successfully if recognized early and appropriately treated. In this chapter I will present a widely accepted postoperative plan with the emphasis on prevention of complications by preemptive actions. The post-op period may be arbitrarily divided into three periods, and during these three periods one lays emphasis on different aspects of care. 

- 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 
- The Consolidation Phase 
- Removal of the Fixator and Post Fixator Removal

- Bibliography: 
Postoperative Management During Limb Lengthening

Ilizarov GA. Transosseous Osteosynthesis, Springer Verlag 

Green SA. Physiotherapy during Ilizarov fixation. Tech Orthop. 1990 Dec;5(4):61-65

Aronson J, Bianchi Maiocchi A, eds. Operative Principles of Ilizarov, Williams & Wilkins