Orthopedic Department, Alessandro Manzoni Hospital, Lecco, Italy.
Clin Orthop Relat Res. 2011 Apr;469(4):1175-80. doi: 10.1007/s11999-010-1635-7. Epub 2010 Oct 21.
Fibular hemimelia is partial or total aplasia of the fibula; it represents the most frequent congenital defect of the long bones. It usually is associated with other anomalies of the tibia, femur, and foot.
QUESTIONS/PURPOSES: We reviewed 32 patients with Type III fibular hemimelia treated by successive lower limb lengthening and deformity correction using the Ilizarov method. We had three aims; first, to analyze complications, including the need for reoperation. The second was to assess knee and ankle function, specifically addressing knee ROM and stability and function of the foot and ankle. The third was assessment of overall patient satisfaction.
Thirty-two patients underwent 56 tibia lengthenings and 14 ipsilateral femoral lengthenings. Their mean age and mean functional leg-length discrepancy at initial treatment were 6.7 years and 6.2 cm, respectively. Activity level, pain, patient satisfaction with function, pain, and cosmesis, complications, and residual length discrepancy were assessed at the end of treatment.
The mean number of surgeries was six per case. The healing index was 44.9 days/cm. Although complications were observed during 60 lengthenings (82%), the highly versatile system overcame most of them. Nearly equal limb length and a plantigrade foot were achieved by 16 patients. For two patients, a Syme's amputation was performed. The outcome was considered satisfactory in 17 patients (53%) and relatively good in eight patients (25%).
The Ilizarov technique has satisfactory results for treatment of Type III congenital fibular hemimelia and can be considered a good alternative to amputation.
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
腓骨半肢畸形是腓骨部分或全部发育不全；它是长骨最常见的先天性缺陷。它通常与胫骨、股骨和足部的其他畸形有关。
问题/目的：我们回顾了 32 例采用伊利扎罗夫方法进行连续下肢延长和畸形矫正治疗的 III 型腓骨半肢畸形患者。我们有三个目的；首先，分析并发症，包括再次手术的需要。其次，评估膝关节和踝关节功能，特别是膝关节活动度以及足和踝关节的稳定性和功能。第三，评估患者整体满意度。
32 例患者接受了 56 次胫骨延长和 14 次同侧股骨延长。他们的平均年龄和初始治疗时的功能性肢体长度差异分别为 6.7 岁和 6.2 厘米。治疗结束时评估活动水平、疼痛、患者对功能的满意度、疼痛和美容效果、并发症以及残余长度差异。
每个病例的平均手术次数为 6 次。愈合指数为 44.9 天/cm。尽管在 60 次延长手术中观察到并发症（82%），但该高度灵活的系统克服了大多数并发症。16 例患者实现了肢体长度相等和足底承重。两名患者进行了 Syme 截肢。17 例患者（53%）的结果被认为满意，8 例患者（25%）的结果被认为相对较好。
伊利扎罗夫技术治疗 III 型先天性腓骨半肢畸形的结果令人满意，可被视为截肢的良好替代方法。
IV 级，治疗研究。有关证据水平的完整描述，请参见作者指南。
