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Related Concept Videos

Bones of the Lower Limb: Tibia and Fibula01:10

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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Related Experiment Video

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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Foot centralization for tibial hemimelia.

Akifusa Wada1, Tomoyuki Nakamura, Noriko Urano

  • 1aSaga Handicapped Children's Hospital, Saga bFukuoka Children's Hospital cUrano Orthopaedic Clinic, Fukuoka, Japan.

Journal of Pediatric Orthopedics. Part B
|January 27, 2015
PubMed
Summary

Foot centralization using calcaneofibular arthrodesis is a surgical option for tibial hemimelia. However, many patients require further procedures to correct recurrent deformities.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Limb Deformity Reconstruction

Background:

  • Tibial hemimelia is a congenital condition characterized by underdevelopment of the tibia.
  • Jones type I and II tibial hemimelia often present with significant foot deformities, including equinovarus.
  • Surgical correction aims to improve foot function and alignment in affected children.

Purpose of the Study:

  • To evaluate the long-term outcomes of foot centralization in patients with Jones type I and II tibial hemimelia.
  • To assess the efficacy of calcaneofibular arthrodesis in correcting equinovarus deformity.
  • To identify the rate and types of recurrent deformities requiring secondary surgical intervention.

Main Methods:

  • Nineteen foot centralizations were performed in 14 pediatric patients with Jones type I and II tibial hemimelia.
  • The surgical technique involved calcaneofibular arthrodesis to address equinovarus deformity.
  • Patients were followed for an average of 10.2 years postoperatively.

Main Results:

  • Four out of 19 operated feet (approximately 21%) achieved a plantigrade position without secondary surgery.
  • Fifteen limbs (approximately 79%) required additional surgical procedures to manage recurrent deformities.
  • Common secondary surgeries addressed loss of correction, equinus, varus, adduction, talipes calcaneus, and fibular deformities.

Conclusions:

  • Foot centralization via calcaneofibular arthrodesis has a high rate of recurrence and requires significant secondary interventions in tibial hemimelia.
  • Long-term monitoring is crucial until skeletal maturity to manage potential recurrences.
  • Further research may be needed to explore alternative or adjunctive surgical strategies for improved long-term correction.