Physiotherapy during Ilizarov fixation

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Abstract
A limb stabilized in an Ilizarov external fixator must be used in a physiologic manner for the entire time that the frame is in place. Weight-bearing for lower extremity applications and the functional use of upper limbs are essential for the proper maturation and ossification of either a fracture callus or a lengthening distraction gap. Progressive weight-bearing begins on the day following application of the fixator. Any reason for a decline in a patient's ambulatory capacity during treatment (eg, pain, wire sepsis, contractures) must be corrected. Likewise, during any Ilizarov procedure involving movement of bone segments—whether lengthening, deformity correction, or bone transport—myofascial tissues resist elongation, leading to either gradual deformity at the site of a corticotomy or joint contractures that can progress to subluxations and dislocations. For this reason, intensive physiotherapy, dynamic and static splinting, and proper night positioning must be employed for the entire time a patient is in fixation.

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