Leliefeld Karolien, Van Der Sluijs Hans, Van Der Haven Ibo
Department of Orthopaedic Surgery, Amstelland Hospital, Amstelveen, The Netherlands.
Acta Orthop Belg. 2009 Dec;75(6):842-6.
Only very few cases of congenital anterolateral bowing of the fibula have been described in literature. We report a girl with congenital anterolateral bowing of the fibula with a 24 year follow-up. Asymptomatic bowing of her left leg below the knee was noted at the age of three years. Radiographs showed an isolated anterolateral bowing of the fibula with a normal ipsilateral tibia. Supervised neglect was advised. A spontaneous fracture occurred one year later. A shortening osteotomy resulted in solid consolidation of the fracture. At the age of 27 years the deformity had progressed into a two-level fracture of the fibular diaphysis with pseudoarthrosis. The segment in-between the fractures was resected. Following this, the patient returned to a normal level of activities in just a matter of weeks. She could even participate in recreational tennis six weeks after surgery and was then discharged from the outpatient clinic. Isolated congenital anterolateral bowing of the fibula is a very rare condition and there is no consensus on its treatment. In this case, removal of the painful pseudarthrotic fragment of the fibula led to a good result.
文献中仅描述了极少数先天性腓骨前外侧弓形弯曲病例。我们报告了一名患有先天性腓骨前外侧弓形弯曲且随访24年的女孩。她三岁时被发现左腿膝盖以下有无症状的弓形弯曲。X线片显示腓骨孤立性前外侧弓形弯曲，同侧胫骨正常。建议采取观察等待策略。一年后发生了自发性骨折。缩短截骨术使骨折牢固愈合。27岁时，畸形发展为腓骨干双平面骨折并伴有假关节。切除骨折之间的节段。此后，患者在短短几周内就恢复到了正常活动水平。术后六周她甚至能够参加娱乐性网球活动，随后从门诊出院。孤立性先天性腓骨前外侧弓形弯曲是一种非常罕见的病症，对于其治疗尚无共识。在本病例中，切除腓骨疼痛的假关节碎片取得了良好效果。
