Leg lengthening and deformity correction in fibular hemimelia using ring external fixator

Abstract

Background: The treatment of fibular hemimelia aims to achieve a functional limb nearly equal in length to the normal limb at maturity, with a plantigrade, stable and flexible foot. The aim of this work was to evaluate the functional results of reconstructive lengthening and deformity correction in fibular hemimelia using the ring external fixator. Methods: This observational study was carried out on 41 patients with fibular hemimelia. The cases either prospectively gathered (sixteen cases, 39 %) to start their management plan or retrospectively collected (twenty-five cases, 61 %) and followed up. Foot reconstruction surgery was done in 22 cases while lengthening surgery applied all cases. All patients were subjected to: history taking, clinical examination (local (lower limb), foot and knee), general examination and imaging. Results: regarding overall results, at the end of follow-up with an average period of 2 years, 4 patients had excellent results (9.76%), 21 patients (51.2%) had good results, 12 patients (29.28%) had fair results and 4 patients (9.76%) had poor result. Regarding subjective functional assessment, out of 41 patients, 20 of them (48.8%) were from 75 to 100% subjectively satisfied, 11 patients (26.8%) from 50 to 74% and 10 patients (24.4%) from 0 to 49% satisfied.