Sutyagin I, Malkova TA. Impact of the Ilizarov apparatus on external fixation: Current modifications of the 75-year-old orthopedic tool. World J Orthop 2025; 16(11): 110465 [DOI: 10.5312/wjo.v16.i11.110465]
Corresponding Author of This Article
Tatiana A Malkova, Department of Medical Information and Analysis, Ilizarov National Medical Research Center for Traumatology and Orthopaedics, 6 M Ulianova Street, Kurgan 640014, Russia. tmalkova@mail.ru
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Orthopedics
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 18, 2025 (publication date) through Nov 20, 2025
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World Journal of Orthopedics
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2218-5836
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Sutyagin I, Malkova TA. Impact of the Ilizarov apparatus on external fixation: Current modifications of the 75-year-old orthopedic tool. World J Orthop 2025; 16(11): 110465 [DOI: 10.5312/wjo.v16.i11.110465]
World J Orthop. Nov 18, 2025; 16(11): 110465 Published online Nov 18, 2025. doi: 10.5312/wjo.v16.i11.110465
Impact of the Ilizarov apparatus on external fixation: Current modifications of the 75-year-old orthopedic tool
Ilia Sutyagin, Tatiana A Malkova
Ilia Sutyagin, The First Department of Orthopaedic, Ilizarov National Medical Research Center for Traumatology and Orthopaedics, Kurgan 640014, Russia
Tatiana A Malkova, Department of Medical Information and Analysis, Ilizarov National Medical Research Center for Traumatology and Orthopaedics, Kurgan 640014, Russia
Author contributions: Sutyagin I was responsible for literature selection, writing and revising the text, preparation of cases; Malkova TA was responsible for study design, literature search and selection, writing and revising the text, preparation of figures and tables; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tatiana A Malkova, Department of Medical Information and Analysis, Ilizarov National Medical Research Center for Traumatology and Orthopaedics, 6 M Ulianova Street, Kurgan 640014, Russia. tmalkova@mail.ru
Received: June 9, 2025 Revised: June 25, 2025 Accepted: September 19, 2025 Published online: November 18, 2025 Processing time: 160 Days and 22.4 Hours
Abstract
The Ilizarov apparatus was designed by its author 75 years ago and addresses a wide range of orthopedic conditions. Its classical assemblies are still self-sufficient and versatile. However, certain clinical scenarios require a more specialized approach, and some groups of patients may benefit from customized Ilizarov constructs. Engineering science has designed various external fixators for orthopedic purposes, and some of those have become the gold standard for specific clinical tasks. We aimed to determine the current state and novel modifications of specialized external fixators for specific clinical situations which are based on the principles of the Ilizarov method. They are half-pin-based fixators for temporal fracture fixation, ring or hybrid devices for gradual deformity correction, and compression-distraction devices tailored for definite limb segments. Gradual correction of deformities can be achieved with external hexapods incorporating universal reduction units. Alternatively, external fixators with special connection mechanisms are able to provide independent movement of the rings in six degrees of freedom. Deformity correction can be performed with combined or sequential use of external and internal fixators. Special devices were developed for moving the split fragment for revascularization of the tibia. The units of external frames on the foot were modified to consider its complex anatomy and the clinical needs ranging from correction of multi-plane deformities, joint arthrodesis to distraction arthroplasty. Mini-fixators are compact external fixators for small bones of the hand and foot. The varieties of external fixators based on the Ilizarov principles have been designed to fulfill an ultimate goal of improving treatment outcomes.
Core Tip: The Ilizarov apparatus was designed 75 years ago and addresses a wide range of orthopedic conditions. Its classical assemblies are still self-sufficient. However, certain clinical scenarios require a more specialized approach, and some groups of patients benefit from customized or modified Ilizarov constructs. They are half-pin hexapod or hybrid fixators for gradual deformity correction, and compression-distraction fixators for definite limb segments. Special devices were developed for moving the split fragment for tibial revascularization. The external frames for the foot and hand were modified to consider their complex anatomy and implement lengthening, correction of multi-plane deformities, and web-space soft-tissue growing.
