Pediatric applications of the Ilizarov method.

Since mid-1987, more than 250 applications of the Ilizarov technique have been successful in treating a variety of pediatric orthopedic problems. The principles of the method are the same in adults and children. Careful preoperative planning and close follow-up evaluation during distraction are important to success. Complication rates are high but improving as experience is gained with the technique. Most complications can be managed such that the ultimate success is not jeopardized. The Ilizarov technique has wide application in the treatment of difficult deformities. The method is useful for treatment of limb-length discrepancy projected to be greater than 5 cm and in limb-length discrepancy combined with angular deformity. The method is applicable to angular deformities such as in adolescent Blount's disease and congenital tibial pseudarthrosis, especially conditions where bone transport may be needed to gain length. In resistant or recurrent clubfeet, the Ilizarov technique is useful as an alternative to osteotomy of the mid- and hindfoot or both. The method may even be indicated for lengthening limbs in selected patients with short stature.