title: Single time angular deformity correction and treatment of knee instability in congenital fibular hemimelia. A case report.
abstract: BACKGROUND
  Fibular hemimelia is the most frequently occurring congenital anomaly of long bones. These patients, among other deficiencies, have a poor development of the anterior cruciate ligament (ACL). Unless it causes clinically assessed instability of the knee, nonsurgical treatment is given. When surgical treatment is required, correction of angular limb deformity must be realized prior to ACL reconstruction.
  
  
  METHODS
  We present the case of a 16-year old patient with congenital fibular hemimelia. Physical examination showed genu valgum, anteromedial rotatory instability and recurvatum of the right knee. We decided to perform surgical correction of the angular deformities and ACL reconstruction in the same surgical time.
  
  
  RESULTS
  Twelve months after surgery, the patient had no evidence of clinical instability, with a range of motion from -5°-110° of the right knee. No claudication or gait instability was found. The KT-1000 arthrometer showed a difference of 2mm between both knees.
  
  
  CONCLUSIONS
  The ACL reconstruction and corrective osteotomies of angular deformities performed in a single surgical procedure had a good clinical result in a 12 month follow up-period, restoring stability of the knee and allowing a normal gait cycle.
authors.affiliation: Orthopaedic Surgery Department, Clínica Alemana de Santiago and Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile.
authors.forename: David
authors.initials: D
authors.lastname: Figueroa
authors.forename: Rafael
authors.initials: R
authors.lastname: Calvo
authors.forename: Ignacio E
authors.initials: IE
authors.lastname: Villalón
authors.forename: Andrés
authors.initials: A
authors.lastname: Schmidt-Hebbel
authors.forename: Francisco
authors.initials: F
authors.lastname: Figueroa
authors.forename: Alejandro
authors.initials: A
authors.lastname: Baar
mesh_terms: D000293:Adolescent; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D001852:Bone Lengthening / Q000009:adverse effects; D004480:Ectromelia / Q000150:complications*; D005260:Female; D005269:Femur / Q000601:surgery; D005360:Fibula / Q000002:abnormalities*; D056304:Genu Valgum / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D010027:Osteotomy / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular; D013977:Tibia / Q000601:surgery