Surgical correction of bowlegs in achondroplasia

A retrospective review of 39 surgical procedures to correct bowlegs in achondroplasia was performed. Three operative procedures had been used sequentially over 27 years. Sixteen tibiae were treated by proximal closing wedge tibial osteotomy, proximal fibular epiphysiodesis and casts. Twelve tibiae were treated by opening wedge osteotomies using external fixation with no fibular shortening. Eleven tibiae were treated by the Ilizarov technique with 3-cm tibial lengthening, deformity correction, and distal translation of the proximal fibula. The Ilizarov technique is the most satisfactory method for correction of proximal bowlegs in early childhood. Distal tibial osteotomy and fibular shortening is recommended for correction of distal bow legs in older children.