SummaryThe title of this article might have been “A Debutante Surgeon's Perspective of the Ilizarov Method.” As a young surgeon from Great Britain, the junior author (M.F.P.) was minimally exposed to the use of the Ilizarov method in trauma applications with an overall magnitude of negative bias. There was very little prior experience with circular frames and like many novice ilizarovian surgeons, M.F.P. dreaded using what appears to be a very cumbersome device. After 8 months with the senior author (M.M.), however, M.F.P. has grown to accept the use of Ilizarov technique as a reliable alternative to more conventional methods of treatment. He realized that the application of a circular frame is not impossible, providing the surgeon adheres to some basic principles. Furthermore, the junior author came to appreciate that the Ilizarov method, once learned, can be successfully used in cases of severe trauma in which conventional techniques such as open reduction and internal fixation are fraught with complications—e.g., major pilon fractures. The junior author's work in the Level 1 Trauma Center (Houston, TX, U.S.A.) with the Ilizarov-trained surgeon produced a surprising discovery: a circular frame can be an extremely useful and versatile device for dealing with severe lower limb fractures.