The Ilizarov bone-lengthening procedure uses a circular external fixator device that attaches to the bone via transfixion wires. A corticotomy (percutaneous osteotomy) is performed, permitting attachment of the wires. Periodic adjustment of the external fixator produces a distractive lengthening force, which gradually stimulates new bone growth.

Bone-lengthening procedures are considered medically necessary for the correction of congenital or post-traumatic limb length discrepancies and angular deformities of the limb (arm, forearm, thigh, or leg). Specific cases include:

• demonstrable non-union or mal-union of long bone with or without bone loss or infection;
• lengthening of an amputation stump where needed for proper fitting of a prosthesis;
• leg lengthening needed to equalize leg length discrepancy greater than 6 cm and to correct congenital or post-traumatic angular/rotational deformations of the long bones;
• bone defects with or without deformities.

Use of a bone lengthening device for lengthening of the upper extremities in the absence of congenital or post-traumatic limb length discrepancies and angular deformities is investigational.

Use of a bone-lengthening device for the sole purpose of altering short stature is not medically necessary.

BlueCard/National Account Issues

The Ilizarov technique is a specialized procedure that may require out of network referral.

A literature search for the period of 1995 through July 2004 reveals that the Ilizarov procedure is an effective and accepted procedure for the correction of congenital or post-traumatic limb length discrepancies and angular deformities of the limb (arm, forearm, thigh, or leg). (1-4)

References:

1. Gugenheim JJ. The Ilizarov method. Orthopedic and soft tissue applications. Clin Plast Surg 1998; 25(4):567-78.
2. Herbert AJ, Herzenberg JE, Paley D. A review for pediatricians on limb lengthening and the Ilizarov method. Curr Opin Pediatr 1995; 7(1):98-105.
3. Tsuchiya H, Tomita K. Distraction osteogenesis for treatment of bone loss in the lower extremity. J Orthop Sci 2003; 8(1):116-24.
4. DeCoster TA, Gehlert RJ, Mikola EA et al. Management of posttraumatic segmental bone defects. J Am Acad Orthop Surg 2004; 12(1):28-38.

Bone Lengthening, Ilizarov Procedure
Ilizarov Bone Lengthening Procedure