[Management of fibular hemimelia with the Ilizarov circular external fixator].
OBJECTIVE
We evaluated the results of treatment with the Ilizarov circular external fixator for limb length inequality and deformities in patients with type IA, IB, and type II fibular hemimelia.


METHODS
Tibial corticotomy and distraction osteogenesis with the Ilizarov technique were performed in five male patients (mean age 11.4 years; range 4 to 20 years). According to the classification of Achterman and Kalamchi, fibular hemimelia was type IA, IB, and II in three patients, one patient, and one patient, respectively. Involvement was on the right in three patients, and on the left in two patients. Two patients had equinus and one patient had valgus deformities. No instability existed in the ankle and knee joints. The mean leg discrepancy was 8.7 cm (range 3 to 16.5 cm), and the mean lengthening index was 1.6 cm/month (range 1.4 to 2 cm). The mean follow-up was 33 months (range 15 to 68 months).


RESULTS
On final examinations, full range of motion of the knee was obtained. A plantigrade foot was achieved in three feet, while two sustained an equinus deformity of 17 and 15 degrees, respectively. Pin tract infections were observed in four patients, all of which were treated with oral antibiotics and dressing. During distraction, three patients had pain. Two patients had a limited range of motion of the ankle joint, without instability or subluxation of the ankle and knee joints. These joint problems were successfully dealt with by physical exercises.


CONCLUSIONS
The Ilizarov technique is a convenient method in the correction of angular and rotational deformities while enabling distraction in type I and type II fibular hemimelia.
Başbozkurt
Mustafa
M
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Gülhane Military School of Medicine, Ankara, Turkey.
Yildiz
Cemil
C
Kömürcü
Mahmut
M
Demiralp
Bahtiyar
B
Kürklü
Mustafa
M
Ateşalp
A Sabri
AS
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005360:Fibula / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome