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Update on Ilizarov’s Circular External Fixator and Method

Morandi, Massimo "Max" MD, FACS; Watson, J. Tracy MD

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doi: 10.1097/BTO.0000000000000148
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In May 1987 at an Association for Osteosynthesis/Association for the Study of Internal Fixation Basic and Advanced course in Colorado Springs, CO, one of the coauthors, (M.M.M.), gave a slide presentation of his initial experience on using Ilizarov techniques. The title of the presentation was “Infected pseudoarthosis and bone defects of the tibia with Ilizarov external fixation.” He was accompanying Professor Bianchi-Maiocchi and Roberto Cattaneo, faculty members at the course. The late Howard Rosen, MD who was also present was intrigued by the presentation, introduced himself and asked to come and visit the Istituti Codivilla—Putti in Cortina d’Ampezzo, Italy, where M.M.M. was practicing just 2 years out of his residency. It started a friendship that lasted a lifetime and was the precursor of the Synthes bone transport frame.

In November of 1987 in New York City, Professor Gavril Abramovitch Ilizarov presented his device and methodology to a renowned gathering of prominent orthopedic surgeons at the first Ilizarov techniques course in the USA. The course was organized and presided over by Victor H. Frankel, MD; with Dr Dror Paley, MD and Dr Morandi as part of the Faculty. J.T.W. and many of the authors of this addition were present.

This initial meeting helped to develop a small cadre of American surgeons in the late 1980s who recognized the potential of this methodology and began to apply these concepts and techniques to difficult contemporary orthopedic problems. At the time, few articles and publications existed in the English literature and these neophyte “Ilizarovian surgeons” had to rely on each other to share their successes and failures, and learn from each other. As well, many of the authors in this edition spent endless hours discussing cases with each other via telephone and FedEx’ed x-rays. (Long before the internet and the ease of communication we now take for granted.)

The 2 coeditors (J.T.W. and M.M.M.) met in 1988 during Dr Morandi’s visit to Cleveland as a visiting professor to discuss the Italian Ilizarov experience. His visit was expedited by another pioneer in external fixation, the late Fred Behrens, MD a great friend and teacher. At the AAOS in 1988, Lorraine Day discussed the paper presented by M. Morandi et al. “Treatment of infected pseudoarthosis of the tibia with and without segmental bone defects with the Ilizarov method,” the very first time a paper using Ilizarov techniques and devices were presented at the American Academy of Orthopaedic Surgeons.

Techniques in Orthopaedics presented an issue on Ilizarov’s method and frame in 1996 and in November of the same year an “International Congress on Advances in the Ilizarov Method” was held in Houston, celebrating the first 10 years of the technique in the USA. The 2 coeditors (J.T.W. and M.M.M.) participated in both the initiatives.

We have selected the authors in this new edition not only because they all started this experience together over 25 years ago………but because they have all become world-renowned “experts” in the areas of traumatology, infection, pediatric and adult deformity, and short stature surgery. These surgeons have taken Ilizarovs’ original concepts and expanded his ideas and applied those using new technologies…… To such an extent that it is barely recognizable in terms of Professor Ilizarovs’ original ring device. We hope that this issue demonstrates the power of the method that all of the authors (as young surgeons) found to be a remarkable innovation, and took it upon themselves to make this a part of their lifelong careers. We would like to thank these talented surgeons for their contributions.

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