Impact of the Ilizarov apparatus on external fixation: Current modifications of the 75-year-old orthopedic tool

Figure 4 Customized external fixation with the Ilizarov frame combined with open reduction and internal fixation after failed closed reduction and cast immobilization of the forearm injury for 1. 5 months in a 66-year-old patient. A: Terrible triad: Mal-alignment of the right forearm with posterolateral dislocation, radial head nonunion, coronoid process malunion, heterotopic ossification; B: Open reduction and internal fixation of the radial head and fixation of the elbow joint with the Ilizarov fixator; C: Gradual reduction of the forearm bones for 8 days; D: Placement of hinges in the axis of the elbow joint upon completion of reduction for active range of motion (ROM); E: Due to obvious ROM limitation, a distraction rod system was attached on the anterior part of the Ilizarov fixator and active ROM continued for 12 days to restore the function of the elbow joint; F: Outcome at 2 months after surgery upon removal of the Ilizarov fixator, bone union and functional recovery.