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Foot centralization for tibial hemimelia

Wada, Akifusaa; Nakamura, Tomoyukib; Urano, Norikoc; Kubota, Hideakia; Oketani, Yutakaa; Taketa, Mayukia; Fujii, Toshioa

Journal of Pediatric Orthopaedics B: March 2015 - Volume 24 - Issue 2 - p 147–153
doi: 10.1097/BPB.0000000000000149

Nineteen foot centralizations were performed in 14 patients with Jones type I and II tibial hemimelia. All feet showed equinovarus deformity and were treated by foot centralization by means of calcaneofibular arthrodesis. The average age of patients at the time of surgery was 1.3 years (range 0.4–3.8 years). The average follow-up postoperative period was 10.2 years (range 2.2–22.9). At the time of the final follow-up, four of the operated feet were plantigrade without secondary surgery. The remaining 15 limbs, however, required secondary surgery to treat postoperative early loss of correction and/or recurrent foot deformities such as equinus, varus and adduction, in addition to talipes calcaneal deformities, and fibular angular deformity at the fibular shortening osteotomy site. The deformities were treated either by repeat foot centralization, or fibular or calcaneal osteotomy. Careful observation for recurrence of the deformity is necessary until the distal fibular epiphysis closes, and the cartilagenous distal fibular end and calcaneus finally achieve ankyloses.

aSaga Handicapped Children’s Hospital, Saga

bFukuoka Children’s Hospital

cUrano Orthopaedic Clinic, Fukuoka, Japan

Correspondence to Akifusa Wada, MD, PhD, Department of Orthopaedic Surgery, Saga Handicapped Children’s Hospital, 2215-27 Kinryu, Kinryu-machi, Saga 849-0906, Japan Tel: +81 952 98 2211; fax: +81 952 98 3391; e-mail:

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