Failure of centralization of the fibula for congenital longitudinal deficiency of the tibia

C. H. Epps, R. E. Tooms, C. D. Edholm, L. M. Kruger, D. D. Bryant

Research output: Contribution to journalArticlepeer-review

Abstract

Between 1962 and 1983, fourteen patients (twenty knees) had centralization of the fibula for congenital longitudinal deficiency: tibial, complete. Eleven of the twenty index procedures were performed on patients who were one year old or less. A progressive flexion deformity of the knee developed after all twenty index procedures. Twenty-six secondary procedures were needed, including disarticulation at the knee, posterior release, extension osteotomy, femorofibular arthrodesis, and biceps-to-quadriceps transfer, and one patient had a second attempt at centralization of the fibula. The duration of follow-up after the initial centralization of the fibula ranged from four years to twenty-two years and seven months (average, twelve years and four months). Seven patients (eight limbs) in whom the index procedure resulted in failure had a satisfactory result after disarticulation at the knee. The patients who did not have secondary disarticulation at the knee are also considered to have had a failed index procedure because they had a flexion deformity at the latest follow-up. Attempts to reconstruct the knee joint by centralization of the fibula are not warranted for patients who have congenital longitudinal deficiency: tibial, complete. Early disarticulation at the knee and fitting with a prosthesis, with close follow-up, is the treatment of choice.

Original languageEnglish (US)
Pages (from-to)858-867
Number of pages10
JournalJournal of Bone and Joint Surgery - Series A
Volume73
Issue number6
DOIs
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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