Limb lengthening in fibular hemimelia type II: can it be an alternative to amputation?

Abstract

The purpose of our study was to analyze limb lengthening in fibular hemimelia type II. Ten patients underwent 16 tibia lengthenings. The mean tibia shortening was 5.8 cm. We used the Ilizarov technique in all cases. The mean follow-up time was 7.2 years. The mean lengthening was 23% of the former length. The healing index was 50.8 days/cm. In the final examination six patients were skeletally mature, equal limb length and functional foot positioning were achieved in four of them. Complications were observed during 14 lengthenings (87.5%). Although lengthening in fibular hemimelia is difficult, elongation with axis and foot correction may offer an alternative to amputation.

Limb Lengthening and Deformity Correction by the Ilizarov Technique in Type III Fibular Hemimelia: An Alternative to Amputation

“…Our rationale from the current study was to assess the results of using the Ilizarov technique in this group of patients and to document the complication rate and incidence of reoperation. We hoped to assess if the long period of treatment and high rate of complications associated with Ilizarov application and preservation of the limb outweigh the results of amputation and use of belowknee prostheses [2,9,13,19,21].…”

“…The introduction of the Ilizarov technique has changed management of fibular hemimelia a great deal. Multiple surgical procedures are necessary to attempt to provide a stable ankle, plantigrade foot, and equal limb lengths in a normal mechanical axis [3,4,6,13,15,21].…”

“…The major functional deficits are severe shortening of the extremity and equinovalgus deformity of the ankle [4,13,15,21].…”

Congenital Fibular Deficiency

“…Recent advances in limb lengthening have stimulated interest in limb salvage reconstruction and have made treatment decisions about whether to attempt limb salvage or to recommend early amputation more complex [21][22][23][24][25][26][27] . The purpose of the present study was to review the clinical experience with patients who were managed at Texas Scottish Rite Hospital for Children for the treatment of congenital fibular deficiency, to determine the treatment-predictive value of prior classification schemes, and to outline a new classification system.…”

Child with a Lower Extremity Trouble

“…Bu olgularda uzatma diğer bir tedavi seçeneği olarak denensede %87.5 e varan komplikasyon oranları ve uzatmanın zorluğu nedeniyle sadece bir alternatiftir. [32] AYAK BİLEĞİ VE AYAK SORUNLARI AYAK ARKININ GELİŞİMİ Büyüyen çocukta ve infantlarda longitüdinal ayak arkındaki düzleşme fizyolojik bir süreçtir. Hayatın ilk dakatında ayak arkı oluşur.…”