Abstract
Treatment protocols of tibial hemimelia comprised joint reconstruction and amputation or knee disarticulation and prosthetic fitting. However, amputation is not acceptable in our community. Therefore we tried to treat these cases without amputation.
From 1993 till 1999, 2 cases of tibial hemimelia type IA, and 4 cases type II were referred to our center. All the cases presented late as the age of patients ranged from 3 _ years to 13 years. For type IA we applied Ilizarov External Fixator on the femur, fibula and foot to centralize the fibula between the femoral candyles and talus using gradual distraction. The second step comprised a Brown procedure. Then, the fixator was reapplied to correct the knee and foot deformities using the bloodless technique. For type II, synostosis of the tibia and fibula was performed followed by differential lengthening. Then we over lengthened the femur. Results: After follow up 2 to 5 _ years all patents were satisfied with good function. The tibial lengthening ranged from 6 to 9 cm and femoral lengthening ranged from 5 to 7.5 cm.
Complications:
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Pin tract infection in all cases.
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Cutting through of the calcanean wires in 2 cases.
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Flexion deformity in 4 cases.
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Fracture of the lengthened femur in one case.
Up to our knowledge this is the first report tfor treatment of complete congenital tibial absence without amputation. Our early results are encouraging, as there are marked functional improvements in these patients.
Local Host: British Society for Children’s Orthopaedic Surgery. Conference Theme: Congenital Deficiencies of the Lower Limb. These abstracts were prepared by A.Catterall.
