The outcome of the use of Ilizarov technique in the management of congenital fibular hemimelia: Review of cases admitted to Erbil Teaching Hospital in Kurdistan region of Iraq

Abstract

Background and objective: Patients affected by fibular hemimelia primarily presented clinically as foot deformities and limb length discrepancies. Surgical restoration of normal limb alignment and length has been reached by using Ilizarov technique. This study aimed to determine the outcome of using Ilizarov procedure in the management of lower limb discrepancy cases in Erbil. Methods: This study is a review of fibular hemimelia cases managed at the orthopedic department of Erbil Teaching Hospital between November 2014 and June 2018. Fibular hemimelia patients complaining from lower limb shortening of 3–11 cm were included in this study. All patients were examined pre and post application of Ilizarov procedure to determine the range of lower limb motion by using the lower extremity functional scale. Ilizarov operative technique was used for the correction of deformities and restoration of normal limb length and alignment. Results: Eight fibular hemimelia patients, including three males, were enrolled in the study with a mean (±SD) age of 7.37 ± 4.13 years (range from 3 to 16 years). They had a mean limb shortening of 6.06 ± 2.36 cm. A wide range of residual deformities and congenital anomalies was reported among fibular hemimelia cases. A number of residual deformities and complications were associated with Ilizarov technique affecting the knee joint, proximal tibia, and ankle joint. Improvement in the lower extremity functional scale from quite a bit and moderate difficulty to a little bit of difficulty (P <0.001) between the two means of pre and postoperative lower extremity functional scale was demonstrated. Conclusion: Ilizarov procedure is effective in improving the lower extremity function in fibular hemimelia despite the associated complications and leg length inequality.