Ilizarov Wire Specification, Uses, Sizes and Surgical Techniques.

Ilizarov Wire

Ilizarov Wire fixators are used to treat fractures that are comminuted or near articular surfaces. They are also widely used in the corrective treatment of non-unions, post-trauma residual misalignment, and limb deformities (by distraction osteogenesis).The Ilizarov method of fracture fixation makes use of pre-tensioned, thin Ilizarov Wires that transfix the bone, supported by circular rings, which are connected using stiff longitudinal bars. Unlike other fixation methods, Ilizarov fixators are characterized by non-linear stiffness in the axial direction. The pre-tensioned Ilizarov Wires behave like beams and cables simultaneously, but with increasing load the cable behavior dominates, and their load carrying capacity changes non-linearly with the sagging of the wires. This results in a geometrically non-linear response in the form of a non-linear load-deflection curve.

Ilizarov Wire Sizes

Our Ilizarov Wires are made from finest quality of SS 316L material to ensure highest quality. There are two types of Ilizarov Wires. (1) Ilizarov Wire with Olive and (2) Ilizarov Wire without Olive. Different sizes of Ilizarov Wires are:

Ilizarov Wire Bayonet Point, 1.5 and 1.8 mm diameter and 400 mm length
Ilizarov Wire Trocar Point, 1.5 and 1.8 mm diameter and 400 mm length
Ilizarov Olive Wire Bayonet Point, 1.5 and 1.8 mm diameter and 400 mm length
Ilizarov Olive Wire Trocar Point, 1.5 and 1.8 mm diameter and 400 mm length

Ilizarov Wires offer many advantages for external fixation of bones in the treatment of nonunions and bone defects and in limb lengthening, which may require prolonged treatment. Tensioning of these wires is critical to their ability to stabilize the bone fragments. Under compression or distraction loads, these wires deflect and increase their stiffness.

Ilizarov wire tensioning and holding methods: a biomechanical study

Aim: To investigate and compare two specific methods of Ilizarov wire tensioning and hold.

Method: This study utilised the vertical Hounsfield test machine H25KS, a stress/strain device with a load-cell linked to a computer program. Firstly, the department’s present mechanical tensioners were assessed. Secondly, the method of twisting the three designs of wire holding bolts to achieve wire tension, as described by Ilizarov, was assessed. These bolts are described as “cannulated”, “slotted” and “Russian” (which are hexagonal headed with a slot down one side).

Results: The mechanical tensioners were found to be accurate, if inefficient, with a maximum producible tension of 1330N. The most effective bolts for creation of tension were the Russian, which produced mean wire tensions of 785N at 45 degrees; 1200N at 90 degrees; 1695N at 135 degrees. The cannulated and slotted bolts regularly broke the wires at 90 degrees twist.

Conclusion: The findings demonstrated two effective methods. The present tensioners were found to be inefficient when compared to the simple twisting of the wire holding bolts, which created equivalent tensions with ease and are capable of producing greater wire tensions. The Russian bolts are recommended for use when wire tension is created by bolt twisting.

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Ilizarov Wire Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include:

Any active or suspected latent infection or marked local inflammation in or about the affected area.
Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site.
Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.
Material sensitivity, documented or suspected.
Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to
failure of the device itself.
Patients having inadequate tissue coverage over the operative site.
Implant utilization that would interfere with anatomical structures or physiological performance.
Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
Other medical or surgical conditions which would preclude the potential benefit of surgery.
All associated diseases which could endanger the function and success of the Ilizarov Wire.

Warnings and Precautionary for Ilizarov Wire

Before using Ilizarov Wire, the surgeon and ancillary staff should study the safety information in these instructions, as well as any product-specific information in the product description, surgical procedures and/or brochures.

Ilizarov Wire is made from medical grade materials and are designed, constructed and produced with utmost care. These quality Ilizarov Wire assure best working results provided they are used in the proper manner. Therefore, the following instructions for use and safety recommendations must be observed.

Improper use of Ilizarov Wire can lead to damage to the tissue, premature wear, destruction of the instruments and injury to the operator, patients or other persons.

It is vital for the operating surgeon to take an active role in the medical management of their patients. The surgeon should thoroughly understand all aspects of the surgical procedure and instruments including their limitations. Care in appropriate selection and proper use of surgical instruments is the responsibility of the surgeon and the surgical team. Adequate surgical training should be completed before use of Ilizarov Wire.

Factors which could impair the success of the operation:

Allergies to implanted materials.
Localized bone tumours.
Osteoporosis or osteomalacia.
System disease and metabolic disturbances.
Alcohol and drug abuse.
Physical activities involving excessive shocks, whereby the implant is exposed to blows and/or excessive loading.
Patients who are mentally unable to understand and comply with the doctor’s instructions.
Poor general health.

Possible Adverse Effects

The following adverse effects are the most common resulting from implantation:

Loosening of the implant, which may result from cyclic loading of the fixation site and/or tissue reaction of the implant.
Early and late infection.
Further bone fracture resulting from unusual stress or weakened bone substance.
Temporary or chronic neural damage resulting from pressure or hematomata.
Wound hematomas and delayed wound healing.
Vascular disease including venal thrombosis, pulmonary embolism and cardiac arrest.
Heterotopic ossification.
Pain and discomfort due to presence of the implant.
Mechanical failure of the implant, including bending, loosening or breakage.
Migration of implant resulting in injury.

Preoperative Planning for Ilizarov Wire

The operating planning is carried out following a thorough clinical evaluation of the patient, Also, x-rays must be taken to allow a clear indication of the bony anatomy and associated deformities. At the time of the operation, the corresponding implantation instruments in addition to a complete set of implants must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of Ilizarov Wire. It is important to determine pre-operatively whether the patient is allergic to any of the implant materials. Also, the patient needs to be informed that the performance of the device cannot be guaranteed as complications can affect the life expectancy of the device.

Ilizarov Wire Precautions

Confirm functionality of instruments and check for wear during reprocessing. Replace worn or damaged instruments prior to use.
It is recommended to use the instruments identified for this screw.
Handle devices with care and dispose worn bone cutting instruments in a sharps container.
Always irrigate and apply suction for removal of debris potentially generated during implantation or removal.

Ilizarov Wire Warnings

Ilizarov Wire can break during use (when subjected to excessive forces). While the surgeon must make the final decision on removal of the broken part based on associated risk in doing so, we recommend that whenever possible and practical for the individual patient, the broken part should be removed. Be aware that implants are not as strong as native bone. Implants subjected to substantial loads may fail.
Instruments, screws and cut plates may have sharp edges or moving joints that may pinch or tear user’s glove or skin.
Take care to remove all fragments that are not fixated during the surgery.
While the surgeon must make the final decision on implant removal, we recommend that whenever possible and practical for the individual patient, fixation devices should be removed once their service as an aid to healing is accomplished. Implant removal should be followed by adequate post-operative management to avoid refracture.

Ilizarov Wire General Adverse Events

As with all major surgical procedures, risks, side effects and adverse events can occur. While many possible reactions may occur, some of the most common include: Problems resulting from anesthesia and patient positioning (e.g. nausea, vomiting, dental injuries, neurological impairments, etc.), thrombosis, embolism, infection, nerve and/or tooth root damage or injury of other critical structures including blood vessels, excessive bleeding, damage to soft tissues incl. swelling, abnormal scar formation, functional impairment of the musculoskeletal system, pain, discomfort or abnormal sensation due to the presence of the device, allergy or hypersensitivity reactions, side effects associated with hardware prominence, loosening, bending, or breakage of the device, mal-union, non-union or delayed union which may lead to breakage of the implant, reoperation.

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Ilizarov Wire Specification, Uses, Sizes and Surgical Techniques.

Ilizarov Wire Sizes

Ilizarov wire tensioning and holding methods: a biomechanical study

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