A pediatric patient with a congenital or developmental deficiency of the fibula with a limb length discrepancy may benefit from a procedure to correct the inequality.
Indications for limb lengthening procedure – all of the following:
(1) foot with 4 or 5 rays (ray = metatarsal or most of a metatarsal)
(2) predicted discrepancy of the limb at skeletal maturity of <= 8 cm
(3) stable, mobile ankle
(4) plantigrade foot (walking with the full sole of the foot)
(5) capable, multi-disciplinary team
Additional factors affecting decision:
(1) family
(2) social
(3) cultural
Techniques for limb length inequality correction:
(1) epiphysiodesis
(2) limb lengthening with or without epiphysiodesis
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