Unilateral tibial hemimelia with leg length inequality and varus foot: External fixator treatment

A 15-year-old girl with type II unilateral hemimelia presented with a 13.5- cm shortening of her right leg, absence of the distal half of the tibia, ti biofibular synostosis, and medial dislocation of a cavus and varus foot. Sh e was treated by means of an external fixator. The shortening was significa ntly corrected, and realignment of the foot with the limb was achieved. An arthrodesis of the talus and lower end of the fibula was carried out operat ively and stabilized with an external fixator. In the same surgical procedu re, we performed an osteotomy of the tibiofibular synostosis, and progressi ve distraction was done with another external fixator. We emphasize the adv antages of progressive distraction for the correction of congenital deformi ties of the limbs.