Amputation or limb-lengthening for partial or total absence of the fibula.

Outcome of limb lengthening in fibular hemimelia and a functional foot

“…Early results with Wagner's technique for limb lengthening were disappointing, with a high rate of complications observed [4]. With the introduction of Ilizarov's method of limb lengthening and deformity correction, several centres have reported encouraging results with significant Knee contracture was defined as less than 45 degrees of movement lengthening and preservation of the foot [12,13].…”

“…With the introduction of Ilizarov's method of limb lengthening and deformity correction, several centres have reported encouraging results with significant Knee contracture was defined as less than 45 degrees of movement lengthening and preservation of the foot [12,13]. Of the studies that have attempted to compare amputation and reconstructive surgery, all have suggested that results were better in the amputation group in severe fibular hemimelia as regards to function, complications and number of operations [4,10,11]. The main criticism of these studies has been that they were retrospective comparisons of small, unmatched patient populations [14].…”

“…The two main surgical options for treatment are reconstructive or ablative surgery [4]. In our institution, we have used both of these options and based our decision on the extent of foot deformity present.…”

Management of Fibular Hemimelia

“…Choi et al 6 reported 88% satisfaction in patients who had amputation as against 55% in patients who had Wagner lengthening. Epps also preferred to preserve the foot and use repeated lengthenings for limb-length discrepancies, angular and rotational deformities, and foot and ankle deformities.…”

“…Many authors recommend early amputation of the foot and prosthetic rehabilitation. [5][6][7][8][9] The advantages of this approach are a single surgical procedure, a short hospital stay, and immediate walking and equalisation of limb length so that the child can adapt quickly and lead a normal life. The major disadvantages are that amputation is irreversible and that prosthetic limbs require periodic replacement and cannot provide normal sensation and proprioception.…”