title: Prevention of recurrence of tibia and ankle deformities after bone lengthening in children with type II fibular hemimelia.
abstract: OBJECTIVE
  This study aimed to evaluate development of the tibia after Ilizarov lengthening and deformity correction depending on whether or not the simultaneous resection of fibular anlage was performed in children with fibular aplasia type II, who did not undergo early surgery.
  
  
  METHODS
  The study analyses results of reconstructive treatment in 38 children at the age of over four years. Two groups of children are compared: bifocal tibial lengthening with the Ilizarov device (group I) and bifocal lengthening associated with resection of the fibular anlage (group II). The results were estimated at 12 months and in the long-term exceeding three years.
  
  
  RESULTS
  Radiological data of measurement of the anatomical lateral distal tibial angle (aLDTA) show surgical correction of deformities achieved in both groups. During the further limb growth a tendency to normalisation of the aLDTA was observed only in the group II. Quick relapse of the angular deformities of the tibial shaft in the first group occurred mainly during further growth of the limb regardless of complete correction at the time of treatment. On the other hand, there were no recurrences of diaphyseal deformities in the group II.
  
  
  CONCLUSIONS
  In children with congenital fibular deficiency of type II at the age of four years, the bone lengthening and deformity correction should be associated with fibular anlage resection. That approach improves conditions for distal tibia development and prevents or decreases significantly the recurrence of deformities of the tibia and ankle joint in long-term follow-up.
authors.affiliation: Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics, 6, M.Ulyanova street, 640014, Kurgan, Russian Federation.
authors.forename: Arnold
authors.initials: A
authors.lastname: Popkov
authors.forename: Anna
authors.initials: A
authors.lastname: Aranovich
authors.forename: Dmitry
authors.initials: D
authors.lastname: Popkov
mesh_terms: D000843:Ankle Joint / Q000601:surgery; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D004480:Ectromelia / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005360:Fibula / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D011859:Radiography; D019651:Plastic Surgery Procedures; D012008:Recurrence; D012189:Retrospective Studies; D013639:Tarsal Bones / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*
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