PMC9372609_01
Anteroposterior X-ray view. (a) An 11.5-year-old boy showed congenital fibular deficiency with a total 8.8 cm shortening of the right femur and tibia, genu valgus, and was missing lateral feet in an equinovalgus position. (b) A double Ilizarov frame, including a femoral segment and a tibial segment, were connected with two straight/flexure device on the level of the knee joint. (c) The bony callus was observed almost consolidated 28 weeks after operation after lengthening, lasting for 5 weeks on the femur and 8 weeks on the tibia. (d) After 40 weeks of the operation, the double-Ilizarov frame was removed. (e) At a 3.5-year postoperative follow-up, the limb length discrepancy was 1.5 cm.
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F1
On anteroposterior (AP) radiographs, the length of the right femur and tibia were 39.0 and 30.0 cm, respectively, while on the left they were 42.4 and 35.4 cm, respectively (Figure 1a). The femoral and the tibial segments were connected with two straight/flexure devices on the level of the knee joint to stabilize the tension of ACL and the soft tissue of the knee joint so as to prevent against knee dislocation during lengthening (Figure 1b). The connecting rods between the femoral and tibial segment of this double-Ilizarov frame were also removed and a plantigrade foot was achieved (Figure 1c). The Ilizarov frames were completely removed at 40 weeks (Figure 1d). At follow-up, the limb length discrepancy was 0.3 cm, 0.96 cm, and 1.5 cm at 1 year, 2 years, and 3.5 years postoperatively, respectively (Figures 1, 2).
Physical examination at 3.5-year postoperative follow-up. There was a 1.5 cm limb length discrepancy cosmetic of his right lower extremity (a,b). The flexion functional examination of the right knee showed moderate restriction (c,d).
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F2
At follow-up, the limb length discrepancy was 0.3 cm, 0.96 cm, and 1.5 cm at 1 year, 2 years, and 3.5 years postoperatively, respectively (Figures 1, 2). The flexion functional examination of the right knee showed moderate restriction (Figure 2).