Document Detail

Limb lengthening and deformity correction by the Ilizarov technique in type III fibular hemimelia: an alternative to amputation.
MedLine Citation:
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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Publication Detail:
Type:  Journal Article     Date:  2010-10-21
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Apr 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  1175-80     Citation Subset:  AIM; IM    
Orthopedic Department, Alessandro Manzoni Hospital, Lecco, Italy.
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MeSH Terms
Ankle Joint / physiopathology,  surgery
Child, Preschool
Ectromelia / classification,  physiopathology,  radiography,  surgery*
Fibula / abnormalities,  radiography,  surgery*
Ilizarov Technique* / adverse effects
Infant, Newborn
Knee Joint / physiopathology,  surgery
Leg Length Inequality / physiopathology,  radiography,  surgery*
Limb Salvage
Patient Satisfaction
Range of Motion, Articular
Recovery of Function
Retrospective Studies
Tibia / abnormalities,  surgery
Time Factors
Treatment Outcome

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