Stürz H, Witt A N
Z Orthop Ihre Grenzgeb. 1980 Dec;118(6):862-7. doi: 10.1055/s-2008-1053340.
The paper reports the result of operative treatment in a case of total congenital absence of the tibia. The boy was treated conservatively by plaster casts and apparative supports until he was six years old. Then the upper end of the fibula was set into the intercondylic fossa of the femur and two months later a talofibular fusion correcting the clubfoot deformity was performed. 32 years after this procedure the leg is now 28 cm shorter. The knee joint is absolutely stable in extended position and active flexion is possible to 45 degrees. The fibula shows a remarkable hypertrophy and has changed its form into a tibia-like bone. The patient is able to walk 15 km without any pain using a supporting apparatus. In congenital absence of the tibia or fibula we prefer orthopedic - surgical devices which preserve the dysplastic part of the limb instead of primary amputation.
本文报道了一例先天性胫骨完全缺如的手术治疗结果。该男孩在6岁前一直采用石膏固定和器械支撑进行保守治疗。之后，将腓骨上端置入股骨髁间窝，两个月后进行距腓融合以矫正马蹄内翻足畸形。该手术32年后，患侧下肢短缩了28厘米。膝关节在伸直位时绝对稳定，主动屈曲可达45度。腓骨明显肥大，形态已转变为类似胫骨的骨头。患者使用辅助器械能够无痛行走15公里。对于先天性胫骨或腓骨缺如，我们更倾向于使用保肢的矫形外科器械，而非一期截肢。
