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Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 82-85

Complications related to fibula resection during tibial lengthening performed with the Taylor Spatial Frame

Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara machi, Kanazawa, 920 8641, Japan

Correspondence Address:
Hidenori Matsubara
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920 8641
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2455-3719.190709

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Context: Previous studies report that valgus deformities of the knee and the ankle joint usually occur due to proximal and distal fibular migration during tibial lengthening with the Ilizarov method. Aims: This study aimed to evaluate complications related to fibular resection during tibial lengthening with the Taylor Spatial Frame. Settings and Design: Retrospective study. Subjects and Methods: We retrospectively reviewed 18 segments (15 patients, mean age 20.5 years) who underwent tibial lengthening of more than one cm with fibular resection. Only Taylor Spatial Frame external fixators were used. The mean follow-up period was 37.8 months. Radiographs were evaluated for proximal fibular migration (PFM), distal fibular migration (DFM), knee and ankle alignment, and the presence of fibular nonunion preoperatively and at the last follow-up. Statistical analysis used: Mann-Whitney U-test. Results: The mean PFM was 9.7 mm and the mean DFM was 3.9 mm. Neither knee nor ankle valgus deformities was seen. Nonunion occurred in 12 segments and union of the fibula occurred in six segments after lengthening. The mean length of the fibular segment was 12.4 mm in cases with nonunion and 5.8 mm in cases with union at the fibula resection sites. Conclusions: We verified the presence of proximal and distal fibular migration reportedly associated with knee valgus and ankle valgus. PFM was not regarded as a definite cause of knee valgus, but it is necessary to fix the tibiofibular joints by transfixing wire and/or cannulated screws both at proximal and distal to minimize PFM and DFM.

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