Features of surgical treatment of children with congenital fibular hemimelia

Purpose. To study leg development after lengthening according to Ilizarov depending on the scope of soft tissue intervention. Material and Methods. The results studied in 52 consecutive cases of surgical treatment of 38 patients (20 girls and 18 boys) with congenital fibular hemimelia. There were two groups of cases: Group I (25 cases, mean age of patients 7.0±1.5 years) underwent leg bifocal distraction osteosynthesis by the Ilizarov method without intervention in the fibrous fibular band; Group II (27 cases, mean age of patients 5.5±1.8 years) – leg bifocal distraction osteosynthesis combined with excision of the fibrous fibular band part. Results. The achieved amount of lengthening was 5.6±2.6 cm (28.1±4.8 %) on the average for Group I, and 5.4±1.8 cm (27.3±3.9 %) – for Group II. Quick recurrence of angular tibial shaft deformities occurred substantially in Group I during further limb growth despite complete correction in the process of lengthening. There were no shaft deformity recurrences in Group II, or they were not significant. Conclusion. Resection of the fibrous fibular band preferable for leg lengthening in children with congenital fibular ectromelia because it improves the conditions for the ankle formation, and prevents or significantly reduces the degree of tibia and the ankle deformity recurrence in the long-term period.