Walking on Air
Ilizarov Method Solves Complex
Musculoskeletal Problems
When Ashley Carbaugh shops at the mall
with her
mother these days, she likes
to look at “fancy
shoes.” She dreams of the day
when she can wear
dressy sandals, or even just
hang out in flip-flops.
Until recently, she could only wear lace-up shoes
due to a congenital clubfoot she had lived with
for
all of her 18 years. The condition forced her
to walk
on her tiptoes, and while she could play
soccer and
work as a restaurant hostess, strappy shoes
were out
of the question.
Then there were the muscle aches and joint pains,
especially after she had been on her feet for a long
time, and people tended to stare at her when she
was
out in public.
Some earlier surgeries to lengthen tendons had been
unsuccessful, and Ashley had just about given up hope of
walking like most other people—until she learned about
Anton Plakseychuk, MD, PhD, and the special surgery in
which he is trained, known as the Ilizarov method.
Using the technique developed in Russia, Dr. Plakseychuk
is able to lengthen bones and limbs by using the body’s
natural regenerative powers to solve complex
musculoskeletal
problems. Fewer than 20 other programs in
the United
States offer the surgery, which the New England
Journal of
Medicine said has “swept across the West and
forever altered
the face of orthopedic surgery.”
Many Applications, Many Benefits
Limb-lengthening procedures may be used for cosmetic purposes, with the ability to add three inches to a person’s height by making his or her leg bones longer.
“It is a method that has many applications and many benefits,” says Dr. Plakseychuk, known to many of his patients as Dr. Anton. “It can solve many problems that would be much more difficult using conventional surgery.”
Ashley, who lives with her family in Loysburg, Pa., about 2 ½ hours east of Pittsburgh, had tried many types of treatment, but was reluctant to undergo more surgical procedures. She was referred in January 2008 to Dr. Plakseychuk by W. Timothy Ward, MD, chief of Pediatric Orthopaedic Surgery at Children’s Hospital.
“We had been told about a doctor in Baltimore who did the procedure, but Ashley didn’t want to have it done because it scared her,” recalls her mother, Vicki. “Then we met Dr. Anton in Pittsburgh, and he put her at ease. They seemed to have an instant rapport. He explained how it worked and made her feel very comfortable.”
The Ilizarov surgery involves breaking the bone and installing an external device—known as a “halo”—with metal rods attached with pins to each half of the severed bone. Over the next few months, the patient turns screws in the halo several times a day to achieve new bone growth in the widening space between the bone sections.
Genesis of the Ilizarov Method
Photos show the progression of one patient before, during and after undergoing the Ilizarov method.
The Ilizarov method was developed by Prof. Gavril Ilizarov, a Russian orthopaedic
surgeon (1921–1992).
While working as head of surgery in a rural hospital during the 1950s, Prof. Ilizarov discovered that after carefully severing a bone and separating the two halves slightly, new bone would grow to fill the gap. By developing an external frame apparatus to continue separating the bone segments by small amounts every day, he found that a bone could be extended by 20 percent to 30 percent of its original length.
In 1961, Prof. Ilizarov created the Kurgan Center of the Restorational Surgery and Orthopedy, purportedly the world’s largest orthopaedic center, which he ran until shortly before his death in 1992.
Lengthening of the bone begins about a week after surgery and continues over the next few months. New bone growth is achieved by the patient turning a series of screws in the Ilizarov frame—or “halo”—several times a day.
On average, patients gain one millimeter of new bone per day. Up to two hours of physical therapy are required every day to allow muscles, tendons and soft tissue to adapt to the new bone size.
Currently, the Ilizarov method is performed at fewer than 20 medical centers nationwide—one of which is Children’s Hospital of Pittsburgh of UPMC.
“Dr. Anton Is Great.”
Ashley, who plans to pursue a career in nursing, gets right to the point when describing her experience, using some of the highest terms of praise in a teenager’s vocabulary.
“Dr. Anton was a really cool doctor and everything like that,” she says. “He explained it really well, and after the surgery he was an awesome doctor. He has a good sense of humor.”
Dr. Ward says the addition of Dr. Plakseychuk, who trained with Prof. Gavril Ilizarov in Russia, further reinforces the reputation of Children’s Hospital of Pittsburgh of UPMC as one of the premier pediatric hospitals in the world.
Now in the final stages of recovery, Ashley says the only discomfort she felt after surgery was relieved with muscle-relaxing medication to address cramping in her leg.
“I don’t regret it because I’m happy to be walking around on two feet flat on the ground,” she says. “I’d recommend it to anyone. Dr. Anton is great.”
About Dr. Plakseychuk
Anton Y. Plakseychuk, MD, PhD, recently joined the staff of the Division of Pediatric Orthopaedic Surgery at Children’s Hospital of Pittsburgh of UPMC, and the Department of Orthopaedic Surgery of the University of Pittsburgh Medical Center. He is an assistant professor of Orthopaedic Surgery at the University of Pittsburgh School of Medicine.
He trained and worked for three years with Prof. Gavril Ilizarov, founder of the eponymous revolutionary limb-lengthening procedure, and has 20 years of clinical and research experience in limb lengthening and correction of skeletal deformities such as clubfoot and clubhand. He is establishing a Limb Lengthening and Reconstruction Center at Children’s Hospital.
Dr. Plakseychuk received his medical degree from Kazan State Medical University in Russia and completed his residency at UPMC. He completed fellowships in sports medicine, hip arthroscopy and hip disorders and joints reconstruction at the University of Pittsburgh; surgical navigation, robotics and computer-assisted orthopaedic surgery at Carnegie Mellon University and the University of Pittsburgh; orthopaedic trauma surgery at the University of Pittsburgh; and upper extremity, hand and microsurgery at the University of Pittsburgh.
Dr. Plakseychuk sees patients at Children’s Hospital and at UPMC’s Liliane S. Kaufmann Building, both in Oakland. For appointments, call 412-687-3900.
