External limb lengthening methods: Ilizarov and Holyfix
In this article, we will try to put some light on external limb lengthening methods, the most common of which are the Ilizarov and Holyfix methods.
We already know Ilizarov is the first successfully and widely used one among external limb lengthening methods out there. It has been the number one choice of the people who want to grow taller, for decades. Ilizarov method is being abandoned in favor of more modern, comfortable, safe, and reliable methods that are being developed. However, it is still used by many doctors all over the world and it is the number one go-to method for patients with a minimal budget.
Ilizarov fixator was named after the Soviet surgeon and inventor, Gavriil Ilizarov. It has many variations, modified by various doctors all over the world. Nevertheless, all of these Ilizarov fixators consist of a circular metal frame and thin wires that go through this frame. The circular structure makes the device sturdy and reliable enough to bear the patient’s weight. The pins go through the soft tissue and bone, to hold the bone in place. The frame is adjustable from various points. It is an advantage because it allows the surgeon to correct any deviations of the bone during the lengthening process.
The system has its disadvantages though. These fixators are extremely bulky and heavy. It means especially when applied to femurs, they cause a huge amount of discomfort when walking, and sleeping. Sitting is almost impossible. For this reason, patients with the intention of cosmetic leg lengthening are limited to lengthening tibia. It is also difficult to find a suitable pair of trousers to wear over the fixators. Combined with the long period of fixation, which is up to 1 year or so, one can imagine how exhausting and nerve-wracking the whole procedure can be.
We talked enough about the specifications of the Ilizarov device. Now let’s see how limb lengthening happens with Ilizarov (or Holyfix) method.
How is surgery performed with external limb lengthening methods?
First of all, osteotomy is performed, which means the surgical cutting of the bones. The surgeon installs Ilizarov devices on both legs and the surgery is finished. Patients begin walking, from the next day after surgery. Most types of Ilizarov device allow full weight-bearing, but patients mostly need a walker for the walking first time after surgery.
After approximately 4-5 days, bone distraction begins. The process is quite similar to other methods, patients do the daily 1 mm bone distraction themselves. Depending on the version, there may be a screw or screws to turn, or a special hole to put and turn the key to perform bone distraction.
When you reach the desired amount of height gain, you stop lengthening. Now it is time to wait for your bones to heal completely. Only after full consolidation, the fixators can be removed. It takes approximately 9-12 months for many patients to consolidate.
As in all other limb lengthening surgery methods, it is important to increase leg muscle flexibility with the help of exercises and physiotherapy, otherwise walking and sports abilities would be limited. Also, there would be pain due to high tension in the legs.
From the info we provided it can be clear that the procedure overall is very similar to other limb lengthening procedures such as LON and Precice. In Ilizarov method, there is only external fixation, and no internal fixators are applied. But all other steps are identical.
It is the cheapest method out there but there isn’t a very big price advantage compared to LON method, which has shorter period of fixation. Most of our patients just prefer saving up a little more and going for LON method, instead of struggling for almost a year, carrying Ilizarov fixators on their legs.