Fig. 1
(a–c) Clinical photos show the shortening of the right leg and valgus deformity; (d, e) pre-operative radiographs show upper tibial nonunion with valgus deformity
3 Preoperative Problem List
1.
Atrophic nonunion of the upper tibia which was operated upon two times to achieve consolidation
2.
Cigarette smoker
3.
Tibial shortening 4 cm
4.
Partially stiff ankle (ROM: ext. 5° and flex. 10°) and previously lengthened Achilles tendon
4 Treatment Strategy
The plan was to convert a complex limb reconstruction into a relatively simple linear limb lengthening through: (a) debridement of the nonunion site to achieve the best bone contact and acute deformity correction, (b) application of Ilizarov external fixator for compression of the nonunion and equalization of leg lengths through a distal tibial lengthening osteotomy, and (c) inclusion of the foot in the fixator to avoid development of equinus contracture during lengthening.
5 Basic Principles
Related posts:
6: A 10 cm Traumatic Femoral Defect Treated with a Transport Technique Followed by a Lengthening Procedure. Sequential Use of a Monotube External Fixator and an Intramedullary Rod
28: Proximal Tibial Bone Defect Treated with Intentional Deformity and Bone Transport
30: C3.3 Pilon Fracture Closed. Ilizarov Fixation with Limited Open Reduction of Joint Surface and Distal Tibia Bridging Distraction of Ankle Joint
78: Two-Stage Treatment of a Chronic Foot Dislocation
84: Lapidus Fusion with External Fixation
65: Closed Correction of Club Foot with Ilizarov
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