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Ankle reconstruction in type II fibular hemimelia
Hazem Mossad El-Tayeby1, Amin Abdel Razek Youssef Ahmed
1Orthopedic Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.
Strategies in Trauma and Limb Reconstruction
|March 22, 2012
Summary
Ankle reconstruction in fibular hemimelia (type II) involved advancing the fibular remnant to create a stable ankle mortise. This technique shows promising short-term results for children with this congenital limb deficiency.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Limb Deformity Reconstruction
Background:
- Fibular hemimelia type II presents with complete absence of the fibula and associated foot deformities.
- Reconstruction is crucial for limb lengthening and functional restoration.
- Existing methods may have limitations in addressing the ankle joint instability.
Purpose of the Study:
- To evaluate the efficacy of ankle reconstruction using fibular remnant advancement in patients with fibular hemimelia type II.
- To assess the functional outcomes and stability of the reconstructed ankle joint.
Main Methods:
- Retrospective analysis of 13 patients with fibular hemimelia type II undergoing ankle reconstruction.
- Surgical technique involved excision of fibular anlage, soft tissue releases, and advancement/fixation of the cartilaginous lateral malleolar remnant.
- Radiological and clinical assessments of ankle stability and range of motion.
Main Results:
- All 13 patients achieved a stable ankle post-reconstruction, with no valgus deformity or subluxation.
- Mean ankle range of motion: 27.3° plantarflexion and 18° dorsiflexion.
- The fibular remnant was successfully advanced and fixed to create a functional ankle mortise.
Conclusions:
- Advancement of the cartilaginous lateral malleolar remnant is an effective technique for ankle reconstruction in fibular hemimelia type II.
- This method provides short-term stability and functional improvement.
- Longer-term follow-up is necessary to confirm sustained outcomes.
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