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Academician G.A. Ilizarov

Professor Gabriil Abramovitch Ilizarov – graduated from medical school in the Soviet Union in 1944 near the end of World War II. After graduation, he was assigned to practice in Kurgan, a small town in western Siberia. He was the only physician with hundreds of miles and had little in the ways of supplies and medicine. Faced with numerous cases of

bone deformities and trauma victims due to the war, Professore Ilizarov used the equipment at hand to treat his patients. Through trial and error with hand made equipment, this self-taught orthopaedic surgeon created the magical combination that would cause the bones to grow again. Thus the Ilizarov technique was created.

Ilizarov Technique- The Ilizarov technique/ method of treatment used Prof. Ilizarov’s Principle of DISTRACTION OSTEOGENESIS. This refers to the formation of new bone between two bone surfaces that are pulled apart in a controlled and gradual manner. The distraction initially gives rise to NEO V A SCULARISA TION, which is what actually stimulates the new bone formation. In addition, there is histogenesis of muscles, nerves and skin and in diseases (osteomyelitis, fibrous dysplasia, pseudoarthroses) this new bone replaces pathological bone with normal bone. This is a revolutionary concept in medical science; diseases for which earlier there was no treatment possible can now successfully be treated with Ilizarov Method.

The Ilizarov Method : History

In 1950, Ilizarov moved to Kurgan. In Kurgan, Ilizarov continued to explore ways to achieve improved results in bone healing and immobilization of fractures. While he was studying Mechanics he had an insight into the stability that an external ring with crossed

Typical of Siberia the institute is shaped like a snowflake. Each wing houses a separate clinical service, sharing central facilities of operating room, Radiology, Laboratory and Physical Theraphy.

wires would bring to a fracture setting. He then asked a local metal worker to fashion these specially designed parts for a new orthopaedic device, and as before did his preliminary testing on a broken broom stick. This time Ilizarov became convinced that his invention would provide secure immobilization. He sent an application for a certificate of invention and was invited to Moscow to demonstrate his external fixator. This application for authorship of the device was accepted in June 1952 and was finally approved in 1954.

Entry to Ilizarov’s new hospital called the Russian Ilizarov Scientific Center, Restorative Traumatology and Orthopaedics (RISC, RTO inaugurated in 1983)

When he presented his data at the conferences, other physicians were skeptical because his results of treatment were dramatically shorter. That being said, devices similar to the Ilizarov apparatus started to emerge, in spite of the skepticism, using bow circular and rectangular shaped fixators. One of them was half ring external fixator by Gudushauri in 1954 from CITO. That was the “official” external fixator used in Moscow for many years. At that time Moscow “coryphaei” did not recognize “nonyielding” province director from Siberia.

Front view of the Ilizarov Center.

Prof Volkov was because the director of CITO in 1961 was one of the prominent figures who actively worked against official acceptance of the Ilizarov device and method. In 1968 Prof. Volkov and Prof. Oganesyan, had patented a similar device to the one presented by Ilizarov at the conference on TB of bones and joints in Tomsk in 1963. But Volkov used his prestige and position, promote the application of his device in the Soviet Union and at international conferences. However the fortunes of Dr. Volkov would dramatically shift during perestroika, when he was removed in 1985 from his position as director of CITO. Among the reasons for his dismissal was oppression towards the acceptance and distribution of Prof. Ilizarov’s external fixator and his method.

Despite the negative experiences in Moscow and his first attemps to introduce his new device to the Soviet Union. Prof. Ilizarov and his innovative treatment started to gain recognition locally. In 1955 he became the chief of the department of Trauma and Orthopaedics in the Veterans hospital in Kurgan.

In front of Ilizarov;s monument author with Prof. A.V. Gubin, Director of the Ilizarov Institute.

In 1965, he was awarded the title of “Honored physician of Russia Federation” for his achievements in medicine. He also became known among patients, title as the “Magician from Kurgan”. The ‘title’ and little to do with Ilizarov’s lifelong love of hearing and showing off magic tricks, which became his hobby throughout his life and provided him great joy and relaxation.

Author in the dog square. Dogs are helping in research work

In 1965, the Health Ministry decided to send a group of physicians to Kurgan to observe more clearly the surgery and progress of the patients according to Ilizarov method.

In 1968 Ilizarov operated on Valery Brumel (1942-2003), a famous Russian athlete renowned in international sports, as high jumber who had set six world records during the 1960s. Tragically, he suffered a open fracture of the distal tibia in a motorcycle accident. The accident and his injuries and treatment received wide notice in the Soviet press. Brumel spent 3 years in various clinics and underwent about 20 unsuccessful operations.

Front Gate of the Ilizarov center.

Ultimately, he developed an infected nonunion as well as significant LLD. In 1965, Dr. Golyakhovsky was among the First group of specialists sent to Kurgan to observe and evaluate Prof. Ilizarov’s work. Dr. Vladmir Golyakhovsky was a young successful surgeon from CITO (Central Institite of Traumatology and Orthopaedics, Moscow). Dr. V. Golyakhovsky spent one month in Kurgan and had returned to CITO, Moscow. He was amazed about the treatment and methods of Ilizarov; but Prof. Volkov of CITO was apathetic about supporting the device within CITO.

Meanwhile Valery Brumel was started to lose hope of recovery in CITO. Dr. Golyakhovsky adviced him to go to Kurgan to seek a consultation with Prof. Ilizarov. On being reassured that his infected nonunion could be healed as his LLD of 3.5 cm could be corrected.

In front of Ilizarov;s museum author with Prof. A.V. Gubin, Director of the Ilizarov Institute. That chaika car was used by Ilizarov

The surgery was successful. Brumel resumed his atheletic training session in 1968. These events brought substantial recognition and attention of high officials as well as fame to Prof. Gabriil Abramovich Ilizarov within the Soviet Union. Brumel’s recovery were also published in the U.S. Medical Press, the Journal of Podiatry (Foot disorders) in 1973 and was titled “Kurgan: Revolution in Orthopaedics”.

These media exposure of a famed athlete recovering against such overwhelming odds and prior treatments failures helped to gather support for financing a new orthopaedic Institute in Kurgan in 1971 (KNIIEKOT).

In front of Ilizarov;s monument author with Prof. A.V. Gubin, Director of the Ilizarov Institute.

In 1982 an additional building in the shape of a snowflake was added to expand the clinic, research and diagnostic services of the institute. This snowflake design was an original concept of Prof. Ilizarov to prevent the spread of infection, by placing patient wards furthest away from the administrative center of the building and providing them with independent entrances. In case of serious infection breaking out in one ward, that block could be effectively isolated without interruption of the work of the hospital.

G. A. Ilizarov with Valery Brumel during his treatment in Kurgan
Author iIn the graveyard of Academician G,A, Ilizarov