Hints to cope with Ilizarov Rx after surgery-2

Dressings

        Pin sites need dressings once in every few days. Some pin sites are more prone to give trouble - especially those which are near the movement zones near the joints. These pins need more frequent dressings. There is no fixed time period to do the dressings. Some patients do not need dressing more than once in 7 to 10 days; whereas some may need it every 3rd day.

        In case any pins show sings of redness or infection, dressing may need to be done daily or even twice a day for a while. Oral or parenteral antibiotics need to be taken & sometimes we may need to inject antibiotics at the pin site itself. This is a very effective method of quickly controlling infection.

        Most patients do experience some pin site trouble at some point in time during treatment. In our experience we have never had to abandon treatment due to pin problems in more than 1600 patients. We may need to change pins under anesthesia. This may be considered as inevitable part of treatment and should not because for alarm.

        Our rate of serious pin infection is less than 1% in more than 16,000 pins inserted so far. When you go home, you will have to learn how to do the dressings yourself & take care of the pins. This is the easiest thing to learn & do as getting a doctor/compounder / nurse to come home to do dressing may not be possible.

Please keep a hard board under the last ring so that the heel stays high & the knee is forced to remains straight.

Distraction

        With the Ilizarov device we can do lengthening or deformity correction in any plane - rotation, angulation or translation - using the simple Ilizarov connections. A pair of 10-11 spanners wrenches - are all that are needed & you will be given instructions on the frequency & amount. Usually it is mm 2 to 4 times a day. We usually show you how to in the first few days & thereafter it makes more sense for you to do it on your own - for several reasons.

        Firstly whenever it needs to be done 4 times, you are the best person to do it. Doing the turnings yourself makes you more involved with the project of your Lengthening & it is under your control.

        We have found that most patients can follow the instructions & even uneducated rural people from India manage it quite well.

Please keep a hard board under the last ring so that the heel stays high & the knee is forced to remains straight.

Automated Distractors

        While it may seem a terribly low-tech method of achieving lengthening, please remember that turning nuts on the apparatus with a simple spanner is THE most reliable and simple method & it cannot go wrong. For those of you who wish for something more hi-tech we can always order an automated distracter - a battery operated, PLC based electronic device which achieves 1 mm per day in semi continuous manner. It could usually cost something like Rs.20-40,000 more!


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