Prevention of Ankle Valgus After Vascularized Fibular Grafts in Children

Fragnière, B; Wicart, Philippe; Mascard, Éric; Dubousset, Jean

doi:10.1097/00003086-200303000-00032

Cited by 70 publications

(50 citation statements)

References 9 publications

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“…Many authors recommend arthrodesis or transfixation with a screw of the distal tibiofibular joint in patients with open physis, in order to avoid the valgus deformity of the ankle and proximal migration of the lateral malleolus [5,7,9,11,15,17,22]. Although we frequently observed proximal migration of the lateral malleolus, we could not associate this with clinical complications.…”

Section: Discussionmentioning

confidence: 72%

“…Although we frequently observed proximal migration of the lateral malleolus, we could not associate this with clinical complications. Fragnière et al [5], in 2003, described 20 children with open physes submitted to vascularised fibula grafting, dividing them in three groups: group A, with no prevention; group B, prevention with a transfixation tibiofibular quadricortical screw; and group C, prevention with fibula reconstruction. They observed a lower incidence of valgus deformity of the ankle in the patients with the distal tibiofibular screw fixation.…”

Section: Discussionmentioning

confidence: 99%

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Vascularised fibular graft for the treatment of congenital pseudarthrosis of the tibia: long-term complications in the donor leg

Iamaguchi

Fucs

Costa

et al. 2010

International Orthopaedics (SICOT)

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Treatment of congenital pseudarthrosis of the tibia is still controversial, and vascularised fibula graft is a reliable method for consolidation, although complications can occur in the donor leg after fibula grafting. This study evaluates 16 patients with congenital pseudarthrosis of the tibia (CPT) treated with contralateral fibular graft, with regard to complications in the donor leg, and assesses the influence of distal tibiofibular joint arthrodesis in these complications. All patients with CPT were consecutively submitted to surgical treatment with contralateral fibular graft. The mean follow-up was 94 months, varying from 44 to 162 months. The long-term effects in the donor leg were determined, and 12 cases with distal tibiofibular arthrodesis (group 1) were compared with a group without arthrodesis (group 2). Half of the patients had proximal migration of the lateral malleolus. Eight patients had ankle valgus. Group 1 had an average valgus tilt angle of 5.8°, while group 2 had an average angle of 1.5°. There was no significant difference between the patients with or without distal tibiofibular joint arthrodesis. The patients with a distal fibula remnant smaller than 5 cm had greater valgus tilt angle measurements. Distal tibiofibular arthrodesis was not effective in preventing all the complications in the donor leg; however, it can lessen the severity of the complications. Our results show that a distal fibular remnant greater than 5 cm should be retained to prevent ankle valgus.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Vascularised fibular graft for the treatment of congenital pseudarthrosis of the tibia: long-term complications in the donor leg

Iamaguchi

Fucs

Costa

et al. 2010

International Orthopaedics (SICOT)

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“…There are conflicting data in literature regarding the prevention of ankle valgus using a syndesmotic screw. Fragniere et al [9] in their series of 20 cases concluded that valgus deformity of the ankle can be prevented efficiently with a syndesmotic screw. However their study was done in patients with vascularized fibular graft harvesting and had a follow-up of 4.1 years.…”

Section: Discussionmentioning

confidence: 99%

“…This strategy however may not prevent ankle valgus and hence close follow-up till skeletal maturity is advised. However there are discrepancies in literature regarding of occurrence of valgus deformity following Lagenskiold operation [Soo et al, Moon et al [7,8] vs Fragniere et al [9] ].…”

Section: Introductionmentioning

confidence: 99%

Chronic haematogenous osteomyelitis of fibula diaphysis with pathological fracture and review of literature

Patil¹,

Patel²,

Baviskar³

et al. 2017

Int. J. Orthop. Sci.

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Introduction: Management of fibular osteomyelitis presents various challenges with respect to stability of ankle mortise, poor quality of periosteum and fibular pseudoarthrosis. Case History: We present a case of a 6 year male child with chronic osteomyelitis of fibula and pathological fracture, who was operated with resection of fibula with proximal and distal tibio-fibular syndesmotic fixation. Patient was followed up for One year and was noted to have fibular pseudoarthrosis and 5 valgus deformity of ankle. Discussion: Progressive valgus deformity at the ankle is a known complication that can occur many years after index fibular resection. We noticed a ankle valgus deformity at 3 month post-op which was non-progressive till 1 year follow-up. The valgus was traced retrospectively to be due to syndesmotic fixation of the fibular remnant after fibular resection, thereby adding a valgus force to ankle mortice. This could have been avoided by inserting the syndesmotic screw before fibular resection. This cause should also be kept in mind while evaluating such patients. These patients should also be followed up to detect fibular pseudoarthrosis and progressive valgus ankle deformity.

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“…Konjenital tibia psödoartrozu tedavisi sırasında karşılaşılacak başlıca komplikasyonlar, ayak bileği valgusu, ekstremite eşitsiz-liği ve yeniden kırık oluşmasıdır [1]. Lateral malleolün proksimal migrasyonu, lateral tibial epifizde stres artışına neden olur bu da asimetrik büyüme ile sonuçlanır ve sonuçta valgus deformitesi oluşur [5]. Ekstremite eşitsizliği ya hastalığın sonucu olarak ya da iyatrojenik olarak gelişir [1].…”

Section: Discussionunclassified

Congenital Pseudoarthrosis of the Tibia: Case Reports

Bulut¹,

Karakurt²,

Belhan³

et al. 2015

Ann Clin Anal Med

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ÖzetKonjenital tibia psödoartrozu nadir görülen ve tedavisi oldukça zor bir hastalıktır. Konjenital tibia psödoartrozu, nörofibromatozis ile sıklıkla birlikte bulunur. Özel-likle Boyd sınıflamasına göre tip II ve V yüksek riskli gruptadır. Biz bu çalışmamız-da tip V konjenital tibia pseudoartrozu olan 3 yaşında erkek hastadaki tedavi sonucumuzu sunduk. Anahtar KelimelerKonjenital Psödoartroz; İlizarov; İntramedüller Tespit Abstract Congenital pseudoarthrosis of the tibia is rarely seen disease which is very difficult to treat. Congenital pseudoarthrosis of the tibia is frequently seen together with neurofibromatosis. Especially according to Boyd classification, type II and V are in the high risk group. In this study, we presented the treatment result of the three years old male patient with type V congenital pseudoarthrosis of the tibia.

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Prevention of Ankle Valgus After Vascularized Fibular Grafts in Children

Cited by 70 publications

References 9 publications

Vascularised fibular graft for the treatment of congenital pseudarthrosis of the tibia: long-term complications in the donor leg

Vascularised fibular graft for the treatment of congenital pseudarthrosis of the tibia: long-term complications in the donor leg

Chronic haematogenous osteomyelitis of fibula diaphysis with pathological fracture and review of literature

Congenital Pseudoarthrosis of the Tibia: Case Reports

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