[Conservation of the Foot in the Treatment of Longitudinal External Ectromelia]

We studied 52 congenital longitudinal deficiencies of the fibula in 44 children, 25 girls and 19 boys. We preferred equalization of leg-length discrepancy and correction of equinovalgus deformity of the foot, to amputation. Correction of the deformity in valgus and equinus is obtained at the price of the section of triceps, peroneus brevis and fibula, inserted on the calcaneum. In some cases an open osteotomy of the talocalcaneal synostosis, or an osteotomy of the lower part of the tibia are also necessary. Good correction of foot has been obtained in 62.8 per cent of cases. 39.5 per cent of children have had suitable foot for weight-bearing, with normal shoes, and 23, 25 per cent have had prosthesis for discrepancy. This procedure should be carried out in predictable discrepancies below 150 mm, whereas 89 per cent of children were saved from amputation; this latter is recommended, at early age, for more important discrepancies.