Myotopography in Tibial Lengthening



1 Olga Stepanovna Novikova MD T & O Department, Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics, M.Ulianova, 6, Kurgan, Russia

2 Department of Orthopaedics, Sri Sathya Sai Institute of Higher Medical Sciences, Prashanthigram, Puttaparthi, Andhra Pradesh, India

3 Dept of Radiology, Russian Ilizarov Scientific Centre for “Restorative Traumatology and Orthopaedics”, M.Ulianova, 6, Kurgan, Russia 640005.


Limb lengthening by Ilizarov lengthens not just the long bone, but also the soft tissues too. Damage of the muscles
during corticotomy and their stretching during distraction play a crucial role in occurrence of complications and final
limb function. We present here a systematic codified nomenclature system of each muscle summarising all the
influence that corticotomy and distraction have the particular muscle and demonstrate the same in the setting of tibial
lengthening. This scheme helps the surgeon easily recollect what all muscles are involved in what all ways in each
level of corticotomy thus enabling him to watch out for complications thereof and monitor and accordingly modify the
limb lengthening process.


1. Aslani H, Tabrizi A, Sadighi A, Mirbolook AR.
Treatment of pediatric open femoral fractures with
external fixator versus flexible intramedullary nails.
Arch Bone Jt Surg. 2013; 1(2):64-7.
2. Novikov KI, Subramanyam KN, Kolesnikov SV,
Chegurov OK. Kolesnikova ES. Mundargi AV. Ilizarov
stump lenthening can aggravate phantom limb pain
- a case report. Arch Bone Jt Surg. 2018; 6(3):240-2.
3. Thorey F, Bruenger J, Windhagen H, Witte F. Muscle
response to leg lengthening during distraction
osteogenesis. J Orthop Res. 2009; 27(4):483-8.
4. Paley D. Problems, obstacles, and complications
of limb lengthening by the Ilizarov technique. Clin
Orthop Relat Res. 1990; 250(1):81–104.
5. Ilizarov GA. The tension-stress effect on the genesis
and growth of tissues: Part II. The influence of the rate
and frequency of distraction. Clin Orthop Relat Res.
1989; 239:263-85.
6. Choi IH, Sohn CS, Chung CY, Cho TJ, Lee JW, Lee DY.
Optimum ratio of distraction in double level tibial
lengthening. Clin Orthop Relat Res. 1999; 368:240-6.
7. Aarnes GT, Steen H, Kristiansen LP, Ludvigsen P,
Reikerås O.Tissue response during monofocal and
bifocal leg lengthening in patients. J Orthop Res. 2002;