title: Tibial rotation-plasty for proximal femoral focal deficiency.
abstract: The most common treatment for proximal femoral focal deficiency is amputation at the level of the ankle joint and subsequent prosthetic fitting in the manner used for an above-the-knee amputee. Since 1967, five patients with proximal femoral focal deficiency were treated with the Van Nes procedure -- an 180-degree tibial rotation-plasty to convert the ankle joint to a knee joint. Two of the five patients had excellent results -- the tibial rotation-plasty allowed the ankle joint to function as a knee joint with 90 degrees of flexion and placed it at the level of the contralateral anatomical knee. Fusion of the anatomical knee above the tibial rotation-plasty in these two patients provided a stable tibiofemoral lever arm that functioned as the thigh. Two patients had good results -- satisfactory functional and cosmetic improvement. In the remaining patient, who had associated paraxial fibular hemimelia with absence of the fourth and fifth rays of the foot, the result was a failure.
mesh_terms: D000293:Adolescent; D001174:Arthrodesis; D001186:Artificial Limbs; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000002:abnormalities*; D005360:Fibula / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008722:Methods; D012399:Rotation; D013977:Tibia / Q000601:surgery*