Bending osteotomy through the distal tibial physis in fibular hemimelia for stable reduction of the hindfoot.
Fibular hemimelia is associated with a deformity of the distal tibial epiphysis resulting in a convexity with lateral and posterior slope of the distal joint surface. The deformity results into an equinovalgus position of the foot and ankle and frequently consecutive dislocation of the foot. A new procedure is presented, in with a metaphyseal ostotomy is performed towards the physis in order to bend the postero-lateral third of the distal tibial epiphysis forming a concave distal tibial joint surface. This procedure was done in four feet in three patients at ages between 7 and 20 months combined with soft tissue releases and rebalancing the tendons. At a follow-up between 6 and 42 months the position of the feet is well retained.
Exner
G Ulrich
GU
Department of Orthopaedics, University of Zürich, Zürich, Switzerland. guexner@balgrist.unizh.ch
D004480:Ectromelia / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005360:Fibula / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome