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Congenital Lower Limb Deformities

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Basic Techniques for Extremity Reconstruction

Abstract

Congenital deformities of the lower limb are difficult pathologies for treatment. In this chapter fibular hemimelia, tibial hemimelia, proximal focal femoral deficiency (PFFD), congenital pseudoarthrosis of the tibia are going to be explained. Fibular hemimelia should be named postaxial hypoplasia of lower extremity because it is accompanied by other deformities of lower extremity such as proximal femoral deficiency, coxa vara, congenital short femur, instabilities of knee, tarsal coalition, and ball-and-socket ankle. The purpose is to correct rotational and angular deformity, to correct ankle instability and foot deformity, to eliminate difference of length of the extremity, and to obtain an extremity that can bear weight. Tibial hemimelia or congenital absent tibia is a rare anomaly. Although the conventional treatment is amputation and prosthetic fitting in most centers, centralization of the fibula between the femoral condyles and correction of deformities to attain a functional knee and ankle joint should be performed with circular external fixators. Proximal focal femoral deficiency (PFFD) is a rare congenital disorder characterized by abnormal development of the proximal femur and acetabulum, which results in a lack of integrity, stability, and mobility of the hip and knee joint. The development of distraction osteogenesis and new findings that have given us a better understanding of the pathoanatomy provide the opportunity to reconstruct the extremity. Congenital pseudoarthrosis of the tibia (CPT) is a malformative disorder that requires advanced treatment. Union of fibular pseudoarthrosis and resection of unhealthy bone and soft tissue are important steps of the treatment. Therefore Ilizarov technique with intramedullary nailing provides alignment and lowers the risk of fracture during and after treatment.

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Authors and Affiliations

  1. Orthopaedic Department, Benha University Hospitals, 11 Al Israa street, Mohandeseen, Cairo, Egypt

    Gamal Ahmed Hosny MD (Prof.)

  2. Istanbul Faculty of Medicine, Department of Orthopedic Surgery and Traumatology, Istanbul University, Istanbul, Turkey

    Fuat Bilgili MD, FEBOT

  3. Istanbul Faculty of Medicine, Orthopaedic and Traumatology Department, Istanbul University, Istanbul, Turkey

    Halil Ibrahim Balci MD, FEBOT

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  1. Gamal Ahmed Hosny MD
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  2. Fuat Bilgili MD, FEBOT
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  3. Halil Ibrahim Balci MD, FEBOT
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Correspondence to Fuat Bilgili MD, FEBOT , Fuat Bilgili MD , Gamal Ahmed Hosny MD or Fuat Bilgili MD .

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Editors and Affiliations

  1. Orthopaedics and Traumatology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

    Mehmet Çakmak

  2. Orthopaedics and Traumatology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

    Cengiz Åžen

  3. Orthopaedics and Traumatology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

    Levent Eralp

  4. Orthopaedics and Traumatology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

    Halil Ibrahim Balci

  5. Orthopaedics and Traumatology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

    Melih Civan

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Hosny, G.A., Bilgili, F., Balci, H.I. (2018). Congenital Lower Limb Deformities. In: Çakmak, M., Şen, C., Eralp, L., Balci, H., Civan, M. (eds) Basic Techniques for Extremity Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-45675-1_35

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