Article

Complications related to the fibula during distraction
osteogenesis could cause malalignment. Most published studies have analyzed only
migration of the fibula during lengthening, with few studies examining the
effects of fibular complications. METHODS : We retrospectively
reviewed 120 segments (in 60 patients) between 2002 and 2009. All patients
underwent bilateral tibial lengthening of more than 5 cm. The mean follow-up time
was 4.9 (2.5-6.9) years. RESULTS : The average lengthening percentage was 34%
(21-65). The ratio of mean fibular length to tibial length was 1.05 (0.91-1.11)
preoperatively and 0.83 (0.65-0.95) postoperatively. The mean proximal fibular
migration (PFM) was 15 (4-31) mm and mean distal fibular migration (DFM) was 9.7
(0-24) mm. Premature consolidation occurred in 10 segments, nonunion occurred in
12, and angulation of fibula occurred in 8 segments after lengthening. Valgus
deformities of the knee occurred in 10 segments. INTERPRETATION : PFM induced
valgus deformity of the knee, and premature consolidation of the fibula was
associated with the distal migration of the proximal fibula. These mechanical
malalignments could sometimes be serious enough to warrant surgical correction.
Thus, during lengthening repeated radiographic examinations of the fibula are
necessary to avoid complications.

Langue : ANGLAIS