Limb Lengthening in Patients with Fibular Hemimmelia
Resource
中華骨科醫學雜誌 v.16 n.1 pp.39-44
Journal
中華骨科醫學雜誌,v.16
Journal Issue
n.1
Pages
39-44
Date Issued
1999
Date
1999
Author(s)
LEE, SHEN-CHUNG
SHIH, KOU-ZEN
HUANG, SHIER-CHIEG
Abstract
We reviewed the result of 10 patients (10 limb segments) with fibular hemimelia between July 1989 and June 1998 treated by limb lengthening and corrective procedures with Ilizarov technique. There were 7 boys and 3 girls, all with associated anomalies in the lower limbs. The average age at operation was 11 years 10 months (2 years 9 months to 18 years 8 months ). One case was type Ia, two were type Ib, and seven were type II, according to Achterman and Kalamchi classification. The average preoperative leg length discrepancy was 9.5 cm (range: 5.6 to 15.2 cm).The mean follow-up time was 18.2 months. The evaluations included clinical, functional outcome, radiological results, and patient's satisfaction. The average length gain was 4 cm (2 to 6 cm) in femur and 6.5 cm (4 to 10 cm) in tibia. The lengthening index was 68 days/cm (29 to 143 days/cm) in femur and 45 days/cm (20 to 62 days/cm) in tibia. The complications included pain, flexion contracture of the knee , temporary decrease of foot sensation, pin tract infection , incomplete corticortomy, and callus bending of the tibia. Satisfactory results were obtained in 9 cases, unsatisfactory result in one at the least follow-up. This form of treatment is an alternative to the more traditional Syme's amputation. Although there were many complications, most patients gained satisfactory functional and cosmetic outcome.