Cuervo M, Albiñana J, Cebrian J, Juarez C
Pediatric Orthopaedic Division, Hospital Niño Jesús, Madrid, Spain.
J Pediatr Orthop B. 1996 Winter;5(1):35-8. doi: 10.1097/01202412-199605010-00007.
We describe five cases of congenital hypoplasia of the fibula and the clinical appearance of the patients. The more relevant clinical manifestation is leg length discrepancy, which is usually < 6 cm. The management of this problem has been approached with predictive tables and timing of the epiphyseodesis. Some cases have been treated with tibial lengthening to correct the associated valgus deformity simultaneously. The valgus deformity is secondary to the hypoplasia of the lateral femoral condyle, which can be treated with medial hemiepiphysiodesis of the distal femur. Anterior instability of the knee usually exists due to congenital absence of the anterior cruciate ligament and can complicate lengthening procedures. The hip joint is not involved, but mild shortening of the femur was observed in four cases. Ball and socket joint at the ankle and tarsal coalitions with absent lateral rays of the foot can occur. Management of the leg length discrepancy must be considered in light of all these possible associated defects.
我们描述了5例腓骨先天性发育不全患者的临床症状。较为相关的临床表现是下肢长度差异，通常<6厘米。对于这个问题的处理，采用了预测表和骨骺阻滞的时机。一些病例采用胫骨延长术，同时纠正相关的外翻畸形。外翻畸形继发于外侧股骨髁发育不全，可通过股骨远端内侧半骨骺阻滞进行治疗。由于先天性前交叉韧带缺如，膝关节通常存在前向不稳定，这可能使延长手术复杂化。髋关节未受累，但4例患者观察到股骨轻度缩短。踝关节可出现球窝关节，足部外侧射线缺如可出现跗骨联合。必须根据所有这些可能的相关缺陷来考虑下肢长度差异的处理。
