Abstract：
OBJECTIVE: Management of fibular hemimelia includes either prosthetic care with or without a suitable amputation or tibial lengthening. Many studies have documented the success of both procedures. Most parents of these children refuse an amputation or have no access to good prosthetic care. The author presents a limb-salvage procedure with tibial lengthening and ankle stabilization.
METHODS: Twelve children of fibular hemimelia with 14 extremities had been subjected to limb lengthening after lateral leg release. To correct the valgus procurvatum, double oblique diaphyseal osteotomy (DODO) of the tibia was performed in 11 extremities. The age of the patients ranged from two to 15 years with the median of five years. All were male. The proposed procedure included three stages of loosening, lengthening, and stabilization with ankle arthrodesis at a later stage.
RESULTS: All patients returned for follow-up for the first four years and had been walking on their sensate feet. With DODO followed by fixator/traction could straighten and lengthen the tibia simultaneously and correct the valgus procurvatum. Ankle stabilization provided stability and a plantigrade foot. A follow-up of six to 30 years with a median of ten years has been reported.
CONCLUSIONS: A new procedure of loosening, lengthening, and stabilization of the leg with ankle arthrodesis has been proposed. A follow-up of 30 years with a median of ten years of the said procedure has been reported. The procedure provides a long-lasting plantigrade and painless foot that has sensation and proprioception. An amputation at any level has not been recommended.
METHODS: Twelve children of fibular hemimelia with 14 extremities had been subjected to limb lengthening after lateral leg release. To correct the valgus procurvatum, double oblique diaphyseal osteotomy (DODO) of the tibia was performed in 11 extremities. The age of the patients ranged from two to 15 years with the median of five years. All were male. The proposed procedure included three stages of loosening, lengthening, and stabilization with ankle arthrodesis at a later stage.
RESULTS: All patients returned for follow-up for the first four years and had been walking on their sensate feet. With DODO followed by fixator/traction could straighten and lengthen the tibia simultaneously and correct the valgus procurvatum. Ankle stabilization provided stability and a plantigrade foot. A follow-up of six to 30 years with a median of ten years has been reported.
CONCLUSIONS: A new procedure of loosening, lengthening, and stabilization of the leg with ankle arthrodesis has been proposed. A follow-up of 30 years with a median of ten years of the said procedure has been reported. The procedure provides a long-lasting plantigrade and painless foot that has sensation and proprioception. An amputation at any level has not been recommended.
摘要：
目的：腓骨偏骨的治疗包括有或没有合适的截肢或胫骨延长术的假肢护理。许多研究都证明了这两种方法的成功。这些孩子的大多数父母拒绝截肢或无法获得良好的假肢护理。作者提出了一种具有胫骨延长和踝关节稳定的保肢手术。
方法：12例有14个四肢的腓骨偏侧儿童在腿外侧松解术后接受了肢体延长。为了纠正外翻，在11个四肢进行了胫骨双斜骨干截骨（DODO）。患者的年龄范围为2至15岁，中位数为5岁。都是男性。拟议的程序包括三个松开阶段，加长,并在后期进行踝关节固定术。
结果：所有患者在最初的四年中都返回了随访，并且一直在行走。使用DODO，然后进行固定器/牵引可以同时拉直和延长胫骨，并纠正外翻。踝关节稳定提供了稳定性和平足。据报道，随访时间为6至30年，中位数为10年。
结论：一种新的松动程序，加长,并提出了通过踝关节固定术稳定腿部。据报道，随访时间为30年，中位时间为10年。该程序提供了具有感觉和本体感觉的持久平坦且无痛的足部。不建议任何级别的截肢。
方法：12例有14个四肢的腓骨偏侧儿童在腿外侧松解术后接受了肢体延长。为了纠正外翻，在11个四肢进行了胫骨双斜骨干截骨（DODO）。患者的年龄范围为2至15岁，中位数为5岁。都是男性。拟议的程序包括三个松开阶段，加长,并在后期进行踝关节固定术。
结果：所有患者在最初的四年中都返回了随访，并且一直在行走。使用DODO，然后进行固定器/牵引可以同时拉直和延长胫骨，并纠正外翻。踝关节稳定提供了稳定性和平足。据报道，随访时间为6至30年，中位数为10年。
结论：一种新的松动程序，加长,并提出了通过踝关节固定术稳定腿部。据报道，随访时间为30年，中位时间为10年。该程序提供了具有感觉和本体感觉的持久平坦且无痛的足部。不建议任何级别的截肢。
