Ilizarov appartus
An Ilizarov apparatus treating a fractured tibia and fibula.
Text size
related tags

On July 24, 1992, Dr. Gavril Ilizarov, the self-trained orthopedic surgeon from Siberia who devised a method for generating new bone growth, died at the age of 71. Only toward the end of the Soviet period did word emerge from behind the Iron Curtain about the near-miraculous work that Ilizarov was doing at his hospital in Kurgan, but when it did, orthopedics departments around the world scrambled to adopt his methods for lengthening and straightening bones, and even alleviating dwarfism.

Gavril Abramovich Ilizarov was born on June 15, 1921, in the Belovezh region of Poland, into a family of “Mountain Jews,” as Jews from the Caucasus region, where he grew up, are called. His parents were illiterate peasants, and Gavril himself did not attend any sort of school before age 11. Instead, he spent his early years tending cows with his family. Later, he was chosen for pre-academic schooling, then sent to the Crimea Medical School in Simferopol.

After getting his medical degree in 1944, Ilizarov was assigned to be the lone doctor in the remote town of Kurgan, in southwestern Siberia. Though he was trained as a general practitioner, as a rural doctor in post-World War II Russia, Ilizarov learned to improvise treatments for the numerous patients he encountered who had undergone amputations or suffered from other severe bone deformations and traumas.

One patient treated by Ilizarov had undergone a below-the-knee amputation, and was left with a joint fused at a 90-degree angle, preventing him from being able to use a prosthetic leg. Ilizarov decided to cut the bone and apply external tension to correct the angle and straighten the leg. When Ilizarov left for vacation, he directed the patient to continue tightening the screws attached to the external fixator. He returned to find not just that the leg was straight, but that the bone had grown in where it had been cut.

Dr. Ilizarov then applied that principle to developing a method for extending limbs: He would cut a bone through to the periosteum, its outer layer, separate the two halves apart slightly, and install an apparatus of fixators (rings) and wires around it to maintain outward tension. When the two halves grew to fill in the space – at a rate of about 1 millimeter a day -- he would pull them a little further apart, repeating the process until the desired growth had been achieved.

Ilizarov became widely known in Russia after he treated the Olympic long-jumper Valery Brumel, who had been badly injured in both legs in a 1967 motorcycle accident, and had undergone 14 operations. According to an article about Ilizarov on the website of the American Academy of Orthopedic Surgeons, “Within a year, Brumel jumped two meters. Soon thereafter, Dr. Ilizarov had a brand new 350-bed hospital and more patients than he could treat.”

As the Cold War began to thaw, surgeons outside the Soviet bloc also began to hear about Ilizarov, and make pilgrimages to his clinic in Kurgan, and the communist regime started to sell lucrative licenses to market his technology in Europe and beyond. In 1987, two orthopedists from the United States arrived in Kurgan. They could barely believe what they saw.

“It was as if we landed on a planet in which people’s bones were made of wax,” recalled Dr. Stuart Green to the American academy. “You could do anything you wanted with them. You could stretch them. Bend them. ... [We] knew the rest of the world had to know about this.” Soon, Green’s travel partner, Dr. Victor E. Frankel, from the Hospital for Joint Diseases, in New York, was able to invite Ilizarov to teach his methods to doctors there.

By the time of his death, Ilizarov headed what is today called the Russian Ilizarov Scientific Center for Restorative Orthopedics and Traumatology, one of the world’s largest orthopedic hospitals. He also authored some 600 professional publications, and saw his name attached to 208 medical inventions.