|Limb lengthening and deformity correction by the Ilizarov technique in type III fibular hemimelia: an alternative to amputation.|
|PMID: 20963528 Owner: NLM Status: MEDLINE|
|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.
|Maurizio A Catagni; Makram Radwan; Luigi Lovisetti; Francesco Guerreschi; Nabil A Elmoghazy|
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|Type: Journal Article Date: 2010-10-21|
|Title: Clinical orthopaedics and related research Volume: 469 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2011 Apr|
|Created Date: 2011-03-04 Completed Date: 2011-05-12 Revised Date: 2013-07-03|
Medline Journal Info:
|Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States|
|Languages: eng Pagination: 1175-80 Citation Subset: AIM; IM|
|Orthopedic Department, Alessandro Manzoni Hospital, Lecco, Italy.|
|APA/MLA Format Download EndNote Download BibTex|
Ankle Joint / physiopathology, surgery
Ectromelia / classification, physiopathology, radiography, surgery*
Fibula / abnormalities, radiography, surgery*
Ilizarov Technique* / adverse effects
Knee Joint / physiopathology, surgery
Leg Length Inequality / physiopathology, radiography, surgery*
Range of Motion, Articular
Recovery of Function
Tibia / abnormalities, surgery
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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