1.The origin, theoretical breakthrough and technical progress of limb lengthening
Sihe QIN ; Jiancheng ZANG ; Paley DROR
Chinese Journal of Orthopaedics 2020;40(11):749-754
Ilizarov technology, which led to bone regeneration and limb lengthening, was one of the important milestones in the development of orthopedics in the 20th century. With involving in clinical of evolution, system cybernetics, regenerative medicine, artificial intelligence, 3D printing in the 21st century, the usual orthopaedic category was broken through. The skull, spine, pelvis, fingers, toes and neuropathic ulceration, ischemic gangrene almost can implement regenerate, repair and reconstruction, which further proof that the biological force can inspire the potential of the human tissue regeneration. This paper traced the history of limb lengthening for more than 100 years, expounded the original bone osteotomy, lengthening concept and important biological theory of Ilizarov technique, distraction osteogenesis and distraction histogenesis, and their development in the former Soviet Union, Europe, North America and all over the world. The strengths, weaknesses and continuous improvement of Wagner, Bastiani, Orthofix, Ilizarov fixator and lengthenable intramedullary nail were introduced, and clinical application of different tissue regeneration and reconstruction caused by distraction histogenesis were described in this paper. International Society for Limb Lengthening and Reconstruction and the academic organizations of various countries play important roles in promoting process of continuous development of limb lengthening. The origin and development of limb lengthening and reconstruction in China can be divided into four stages:the stage before Ilizarov technology, namely the independent research and development of external fixation; the stage of Ilizarov technology period of distraction osteogenesis; the stage post-Ilizarov; and the stage of limb regeneration and reconstruction under stress control and regulation, which has now entered a new era of rapid development.