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Limb Lengthening and Reconstruction Surgery

2006 Edition, October 25, 2006

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Active, Most Current

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ISBN: 978-0-8493-4051-2
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Product Details:

  • Revision: 2006 Edition, October 25, 2006
  • Published Date: October 25, 2006
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 728
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


I hope that this book will complement the great classic works in limb lengthening and reconstruction surgery. I have been influenced and educated by Ilizarov's Transosseous Osteosynthesis (Springer Verlag, 1992) and Paley's Principles of Deformity Correction (Springer Verlag, 2002). The former is predominantly an atlas of cases demonstrating the author's pioneering work and the creation of a new discipline. The latter focuses on principles and planning for lengthening and deformity correction using the center of rotation and angulation method.

Interestingly, these classics were not compiled as traditional medical textbooks. My goal was to organize and edit a traditional textbook with many expert contributors that would cover the gamut of limb lengthening and reconstruction surgery. Authors were asked to share their practical approaches to a clinical problem. There are also chapters on basic science and technology. This book is a comprehensive approach to the many state-of-the-art applications of limb lengthening and reconstruction surgery. The book is divided into sections on principles, acute trauma, post-traumatic reconstruction, foot and ankle, knee, hip, pediatric, tumor, upper extremity, stature lengthening, technology, and postoperative care. There are 49 well-defined chapters presented by many leaders in the field from around the globe. In addition, the introduction, The Ilizarov Method: History and Scope, was written by my coeditor and partner, Dr. Svetlana Ilizarov.

This book is a necessity for the practitioner of limb-lengthening reconstruction and deformity correction. The chapters are organized to include an explanation of the clinical problem, a practical approach to each subject, and a concise review of the literature. Tables outlining the authors' classification of each problem subtype and their decision-making with regard to treatment are included. A review of the authors' surgical approach including technical tips, complication management, and clinical case examples are covered in each chapter. Although the authors worked within guidelines, their individuality will show with some heterogeneity of chapter format. Common abbreviations such as leg length discrepancy, anteroposterior, and intramedullary are used liberally throughout the book.

Many people have asked me, ‘‘How did you get into limb lengthening?'' I would like to acknowledge the mentorship, help, and support of many people by briefly telling the story of my orthopedic limb lengthening journey. My mother's dream to become a physician was cut short by the Nazis and her deportation from Romania in 1941. She and my older brother, Jacob Rozbruch, MD, who is a successful New York orthopedic surgeon, were major early role models.

During my residency at the Hospital for Special Surgery, I was turned on to trauma and the AO/Association for the Study of Internal Fixation school. I did an Arbeitsgemeinschaft fu¨ r Osteosynthesefragen (AO) fellowship with Professor Reinhold Ganz in Bern, Switzerland, and this was my first real exposure to osteotomy for deformity correction. After returning to New York, I practiced general orthopedics, with a special interest in trauma, for three years. The most complex post-traumatic problems were bone loss and large deformity, and we did not have a good solution for these. Dr. David Helfet, chief of the Orthopaedic Trauma Service and Dr. Russell Warren, then surgeon-in-chief at the Hospital for Special Surgery encouraged me to take a sabbatical and do a second fellowship to learn the Ilizarov method and to develop a niche at the Hospital for Special Surgery. The Baltimore fellowship with Dr. Dror Paley and Dr. John Herzenberg was life changing. I was amazed by their clinical work. They are great teachers and great men, and I am indebted to them for teaching me the tools of this amazing trade.

When I returned to New York, Dr. Warren gave me the task and opportunity to develop the limb lengthening program at the Hospital for Special Surgery. Although many of the faculty saw this as an exciting new discipline and supported this, others felt that it was only a technique to be used very sparingly and were resistant to this strange ‘‘new'' field. I met Arkady Blyakher who had come to the United States from Russia and was trained by and had worked with G. A. Ilizarov in Kurgan. He and I worked together at the Hospital for Special Surgery for five years on clinical and academic pursuits, and he exposed me to many aspects of the classic Ilizarov method. At one time, he was a great friend and colleague. He introduced me to Svetlana Ilizarov, MD, at one of our holiday parties. Despite her great experience with and knowledge of her father's method, she was surprisingly not involved in this discipline. With the support of John Reynolds, the chief executive officer and president of the Hospital for Special Surgery, and Greg Lutz, MD, the chief of physiatry at Hospital for Special Surgery, I recruited her and we formed the Institute for Limb Lengthening and Reconstruction at the Hospital for Special Surgery. I attended a Taylor Spatial Frame course soon after my fellowship and was exposed to the genius of J. Charles Taylor, MD and his frame/computer program. Immediately, I was seduced by this lengthening and deformity correction machine and began using it feverishly. I met an orthopedic resident named Austin Fragomen, MD, while I was lecturing at a Taylor Spatial Frame meeting. His desire to do a fellowship with me led to the creation of the Limb Lengthening Fellowship at the Hospital for Special Surgery. Austin was my first fellow and student. He taught me how to teach, and his excellence confirmed to me that we had great program. I recruited him to join the faculty and with the leadership, support, and vision of Dr. Thomas Sculco, the current surgeon-in-chief at the Hospital for Special Surgery, we formed the Limb Lengthening and Deformity Service at the Hospital for Special Surgery. We have developed a successful collaborative relationship with the other Hospital for Special Surgery services including foot and ankle, trauma, sports, arthroplasty, hand, and tumor. Joint conferences have been very productive for the sharing of ideas and patients. With more experience, we have come to appreciate the many indications for the Ilizarov method. I thank these people and my many colleagues at the Hospital for Special Surgery who support our work.

A man named Geoff Greenwood from Informa Healthcare publishing house contacted me two years ago and proposed this book project. He helped us organize the job at hand. I also want to thank all the contributors to this book who are giants in this field. Thanks to my coeditor and partner, Dr. Svetlana Ilizarov, the editorial team at Informa Healthcare led by Dana Bigelow, and Nancy Collins, the project editor at The Egerton Group.

While I never met Professor Gavriil A. Ilizarov, I owe a great deal of gratitude to him. His pioneering genius paved the way for our clinical and academic work. Many of the contributors to this book were taught by him first hand. The rest of us learned about the method second hand. It is my hope that this book will stimulate young doctors to explore this subspecialty of orthopedic surgery. Ilizarov's work inspired the formation of the Association for the Study and Advancement of the Method of Ilizarov, which is an international academic society with national branches. The North American branch of the Association for the Study and Advancement of the Method of Ilizarov is one of the subspecialty societies of the American Academy of Orthopaedic Surgeons and is called the Limb Lengthening and Reconstruction Society (www.LLRS.org). I encourage people who are interested in this field to attend and join this society. It is a great place to learn, share ideas, and meet fellow ‘‘Ilizarovians.''