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Bending osteotomy through the distal tibial physis in fibular hemimelia for stable reduction of the hindfoot

Exner, G. Ulrich

Journal of Pediatric Orthopaedics B: January 2003 - Volume 12 - Issue 1 - p 27-32
MALFORMATIONS
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Fibular hemimelia is associated with a deformity of the distal tibial epiphysis resulting in a convexity with lateral and posterior slope of the distal joint surface. The deformity results into an equinovalgus position of the foot and ankle and frequently consecutive dislocation of the foot. A new procedure is presented, in with a metaphyseal ostotomy is performed towards the physis in order to bend the postero-lateral third of the distal tibial epiphysis forming a concave distal tibial joint surface. This procedure was done in four feet in three patients at ages between 7 and 20 months combined with soft tissue releases and rebalancing the tendons. At a follow-up between 6 and 42 months the position of the feet is well retained. 

Department of Orthopaedics, University of Zürich, Forchstr. 340, CH 8008 Zürich, Switzerland

Correspondance and requests for reprints to G. Ulrich Exner, M.D., Professor of Orthopaedic Surgery, Head, Section of Paediatric and Tumor Orthopaedics, BALGRIST, Department of Orthopaedics, University of Zürich, Forchstr. 340, CH 8008 Zürich, Switzerland.

Tel: +41 1 3863090; fax: +41 1 3863099; e-mail: guexner@balgrist.unizh.ch

© 2003 Lippincott Williams & Wilkins, Inc.