A new operation for congenital absence of the fibula. Preliminary report.
نویسنده
چکیده
The treatment of congenital absence of the fibula is difficult, because of the complexity ofthe deformity. This syndrome in its classic form consists of: 1) complete or partial absence of the fibula ; 2) congenital shortening of the extremity ; 3) anterior bowing of the middle and lower parts of the tibia; 4) deformity of the foot (plano-valgus or equino-valgus position of the foot, with complete or partial dislocation of the talo-tibial joint, associated with the absence of the lateral malleolus). Other features that are often observed include primary or secondary bony fusion between the talus and calcaneus (Lapasset and Cahuzac 1935), deformity or even total absence of the talus or of the cuboid bone, or absence of one, two or even three lateral metatarsals with the corresponding toes. Deformity of the foot increases with age, on account of: 1) a fibrous or cartilagino-fibrous strip, which replaces the fibula (Thompson, Straub and Arnold 1957); 2) shortened peroneal muscles which frequently adhere abnormally to the lateral side of the tuber calcanei ; and 3) lateral transposition of the tendons of the long extensor of the toes and of the great toe, caused by valgus deformity of the foot (Gruca 1959). The posterior and lateral parts of the lower epiphysis of the tibia may also be undeveloped (Harmon and Fahey 1937, Ambros 1948, Dubost-Perret 1950, Badgley, Connor and Kudner 1952) or may undergo atrophy because of the asymmetrical loading (Gruca 1959). The deformity becomes fixed during the second and third years of life by capsular, ligamentous and muscular contractures. The disappearance of the supporting function of the extremity, caused by marked deformity, enhances the primary underdevelopment and shortening of the limb, which develop most rapidly between the first and the sixth years of life.
منابع مشابه
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ورودعنوان ژورنال:
- The Journal of bone and joint surgery. British volume
دوره 49 1 شماره
صفحات -
تاریخ انتشار 1967