Clinical Orthopaedics and Related Research®

, Volume 469, Issue 4, pp 1175–1180

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

  • Maurizio A. Catagni
  • Makram Radwan
  • Luigi Lovisetti
  • Francesco Guerreschi
  • Nabil A. Elmoghazy
Clinical Research

DOI: 10.1007/s11999-010-1635-7

Cite this article as:
Catagni, M.A., Radwan, M., Lovisetti, L. et al. Clin Orthop Relat Res (2011) 469: 1175. doi:10.1007/s11999-010-1635-7

Abstract

Background

Fibular hemimelia is partial or total aplasia of the fibula; it represents the most frequent congenital defect of the long bones. It usually is associated with other anomalies of the tibia, femur, and foot.

Questions/purposes

We reviewed 32 patients with Type III fibular hemimelia treated by successive lower limb lengthening and deformity correction using the Ilizarov method. We had three aims; first, to analyze complications, including the need for reoperation. The second was to assess knee and ankle function, specifically addressing knee ROM and stability and function of the foot and ankle. The third was assessment of overall patient satisfaction.

Patients and Methods

Thirty-two patients underwent 56 tibia lengthenings and 14 ipsilateral femoral lengthenings. Their mean age and mean functional leg-length discrepancy at initial treatment were 6.7 years and 6.2 cm, respectively. Activity level, pain, patient satisfaction with function, pain, and cosmesis, complications, and residual length discrepancy were assessed at the end of treatment.

Results

The mean number of surgeries was six per case. The healing index was 44.9 days/cm. Although complications were observed during 60 lengthenings (82%), the highly versatile system overcame most of them. Nearly equal limb length and a plantigrade foot were achieved by 16 patients. For two patients, a Syme’s amputation was performed. The outcome was considered satisfactory in 17 patients (53%) and relatively good in eight patients (25%).

Conclusions

The Ilizarov technique has satisfactory results for treatment of Type III congenital fibular hemimelia and can be considered a good alternative to amputation.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • Maurizio A. Catagni
    • 1
  • Makram Radwan
    • 2
  • Luigi Lovisetti
    • 1
  • Francesco Guerreschi
    • 1
  • Nabil A. Elmoghazy
    • 3
  1. 1.Orthopedic Department“Alessandro Manzoni Hospital”LeccoItaly
  2. 2.Faculty of MedicineZagazig UniversityZagazigEgypt
  3. 3.Department of Orthopedic Surgery, Faculty of MedicineMansoura UniversityMansouraEgypt

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