Activities of a large limb lengthening and reconstruction center in the 21st century

Background: Limb lengthening and reconstruction surgery (LLRS) is a relatively new orthopedic subspecialty. It started to develop in the 1980s when the Ilizarov method became known to the world orthopedic community. Purpose: We evaluated the caseload dynamics and compared the use of the Ilizarov techniques against the total of annual surgical interventions performed at our center. Materials and Methods: We retrospectively examined archival data on the admissions and surgical activities since the center's inception and in several years separately. The total of admissions, surgical activity, and the total of external fixation operations was calculated. We also reviewed all consecutive LLRS cases for a sample period of 2015, assessing admission patterns and surgical categories. Academic activity was reviewed using available databases of medical publications. Results: The total of admissions throughout 45 years was 185,839. The number of admissions reached 12,451 in 2016, almost six times more than in 1986. In 1996, the surgical volume significantly decreased and started to grow significantly from 2011. LLRS reduced relative to the total of operations performed though its absolute number grew by 52.6% in 2016 as compared with 1986. It comprised only 30% in 2016 while other orthopedic and joint pathology techniques were employed in 70% of operations. The number of operations with the Ilizarov method for osteomyelitis increased >4.45-fold in 2016 as compared to 1986. According to the Scopus database, the most productive years were 2015 and 2016 with 50 and 54 articles, respectively, published in the national and international journals. Conclusions: The scope of the center's activities has expanded beyond the Ilizarov method. Many newer technologies for the management of musculoskeletal diseases are employed to meet the needs of the market. Due to growth of musculoskeletal diseases and above mentioned factors, LLRS activity has been constantly growing. Its main concepts are the Ilizarov philosophy, age, and technical continuity