Development of Ilizarov Surgery in Malaysia
Principles of distraction osteogenesis was developed by Ilizarov from Kurgan, Russia, in the middle of last century. However, this treatment method was not known to the rest of the world until June 1981 when Ilizarov was invited to present his work in 22nd Italian AO Meeting in Bellagio, Italy. From Europe, Ilizrov surgery was later adopted by surgeons from North America. In 1988, KS Sivananthan performed Ilizarov procedures on three patients following his visit to United States , and subsequently presented his experince during a conference on the following year. In 1991, the first Ilizarov workshop was organised in Kuala Lumpur. Following this, Dr Sengupta started to perform deformity corrections for children in University Hospital Kuala Lumpur. In 1995, Ilizarov surgery for trauma was started by Dr Thirumal in Hospital Seremban and Dr Saw Aik in University Hospital Kuala Lumpur. Ilizarov procedure has expanded the indications of external fixation from providing temporary immobilization for open fractures to providing definitive fixation for complicated fractures and correction of complex limb deformities.
With increasing popularity of Ilizarov procedure, the first basic Ilizarov course was organised in University Malaya in 1991. Dr. Juanito Xavier from Manila was the invited faculty for this course. Subsequently, advanced Ilizarov course were also organised and Dr Maurizio Catagni was one of the few regular invited faculty for these courses. An informal ASAMI Malaysia group were formed by the local orthopaedic surgeons who are doing Ilizarov surgery to facilitate discussions on difficult cases and provide faculty support for the local courses . In 2004, Limb Lengthening and Recostruction Surgery (LLRS) interest group were formed by Malaysian Orthopaedic Association. Following the introduction of Taylor Spatial frame in 2007 , more courses with hands-on workshops for ring fixator, uniateral fixator and hexapod system have been organised in this country, although the standard Ilizarov ring fixator remained as the most versatile and effordable system. Many courses has been organised in different cities around the country including Kuching, Johor Bahru, Mekala, Bintulu, Sg Petani, Kuala Terengganu, Seremban and Kuantan. In 2009, University Malaya has orgnised the first Limb Deformity Correction Course that provide more comprehensive training for treatment for complex limb deformity. Ministry of Health of Malaysia has also organised advaced trauma fellowships for Orthopaedic surgeons interested in Trauma as a subspecialty.
Malaysia has been activey involved in regional and international ASAMI meetings. Dr Saw Aik has represented the ASAMI Malaysia until 2010 when Dr Thirumal took over the Chairmanship. In 2016 Dr Chua Yeok Pin became the third chairman. The first ASAMI Malaysia Congress was held in 2013 and the second in 2015 in Klang, Malaysia. Since then the ASAMI meetings have been alternating with the National Ilizarov Course. The last Ilizarov course was held in Miri, April 2016. To further popularise this field and to increase the number of surgeons in this field, fellowship trainings was started in University Malaya Medical Centre (previously known as Universiy Hospital Kuala Lumpur) and subsequently in the Ministry of Health. Since then, 7 surgeons have graduated with sub-speciality in Ilizarov from the Ministry of Health. Over the last three years, Orthopaedic surgeons from other countries have come to Malaysia for long and short fellowship attachments to advance their clinical skills in Ilizarov surgery.
ASAMI Malaysia officially registered under ASAMI International in 2013 with about 20 orthopaedic surgeons actively involved in the activities. The organization was registered as a society in 2016 and hopefully it will be able to encougare more young surgeons from Malaysia and this region to specialized in this field to provide better treatment for those with severe trauma, difficult complications, and complex limb deformities.