Complex Deformity Correction and Functional Reconstruction of Lower Limbs

Abstract

The definition and classification of complex deformity of lower limbs is based on whether or not the patient can walk upright and the ability of the lower limbs.

The common feature of complex deformity has dual dysfunction of bone and soft tissue, whether it is a bone deformity caused by muscular imbalance, or a tendon soft tissue contracture secondary to skeletal deformity. Taking together, systemic design is critical for good outcome of complex lower limb deformity correction.

For the patients who cannot stand walking before surgery, the first surgery will be on the less deformed lower limbs. Whereas for the patients who can walk upright before surgery, the first surgery will be more severe lower limb. Those who need staged surgeries should arrange rationally. The second surgery on the same leg should not interfere with the outcome of the first surgery. It is best for one doctor to complete the treatment plan for the patient.

Severe lower limb deformity, especially foot and ankle deformity, co-infection or long-term unhealed foot and ankle deformity caused by foot ulceration of weight bearing area, ankle and foot defect caused by lack of blood circulation are difficult to achieve satisfactory therapeutic effects by traditional treatments, which seriously often suggest amputation and then install the prosthetic to improve the quality of patient’s life.

How can we correct lower limb deformity with imbalanced muscle strength?

How can we treat the severe limb deformity suggested amputation?

The principle of deformity correction and functional reconstruction for complex lower limb deformity in Qin Sihe Orthopedics Institute is as follows:

• 1. Walking. Encourage patient to walk early and walking is part of the treatment. The surgical method selection is based on whether it can create conditions to allow patent walking early.

• 2. Two Lines. Restore the mechanical axis of lower limbs and hip-knee-ankle normal anatomical line.

• 3. Balance. First, bone surgery shall regain balance between bone quality, strength, and stiffness, eliminating stress shielding. Second, rebuild lower limb static and dynamic balance. Third, to rebuild patients mental health.