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Fibular Lengthening for the Management of Translational Talus Instability in Hereditary Multiple Exostoses Patients

Cited 8 time in Web of Science Cited 7 time in Scopus
Authors

Lee, Dong Yeon; Kim, Joong Il; Song, Mi Hyun; Choi, Eun Seok; Park, Moon Seok; Yoo, Won Joon; Chung, Chin Youb; Choi, In Ho; Cho, Tae-Joon

Issue Date
2014-10
Publisher
Lippincott Williams & Wilkins Ltd.
Citation
Journal of Pediatric Orthopaedics, Vol.34 No.7, pp.726-732
Abstract
Hereditary multiple exostoses (HME) patients frequently present with ankle valgus deformity and marked fibular shortening. Loss of the lateral buttress may cause translational talus instability (TTI) that manifests as ankle pain after physical exercise, medial clear space widening on plain radiographs, and gross translational movement of the talus within the mortise. Among 123 HME patients examined and/or surgically treated, 10 patients (14 ankles) with symptomatic TTI underwent fibular lengthening with osteochondroma excision. Twelve ankles of 9 patients were followed for >1 year after surgery. Total fibular length gain averaged 15.3mm and distal migration of the distal fibular fragment averaged 5.5 mm. The mean medial clear space decreased from preoperative 6.7mm to postlengthening 3.5 mm. Gross instability of the talus within the ankle mortise disappeared in all cases. AOFAS ankle-hindfoot score improved from preoperative 80.3 to 97.3 at the latest follow-up. The current study showed the fibular lengthening improved lateral ankle stability by providing lateral buttress on the talus and providing favorable short-term result by ameliorating exercise-induced ankle pain in TTI of HME. The authors carefully conclude that TTI is a rare but potentially disabling condition in HME patients, requiring special attention during follow-up of HME patients. Level of Evidence: Level IV.
ISSN
0271-6798
URI
https://hdl.handle.net/10371/192043
DOI
https://doi.org/10.1097/BPO.0000000000000181
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  • College of Medicine
  • Department of Medicine
Research Area Cerebral palsy, Medical image, Motion analysis, Pediatric orthopedic surgery, Statistics in orthopedic research

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