A Systematic Review of Ankle Reconstruction with Limb Lengthening in Fibular Hemimelia

Background: fibular hemimelia (FH) is a congenital deficiency where part or all of the fibular bone is hypoplastic, dysplastic or aplastic associated with hypoplasia and dysplasia of the tibia and hypoplasia, dysplasia and aplasia of parts of the foot. Objective: this systematic review was aimed to review the different method of ankle reconstruction with limb lengthening in patients with Fibular Hemimelia to restore normal weight-bearing and normal limb length so that the patient can walk with a normal gait as possible. Material and Methods: online search was done using the Medline database on PUBMED, Google Scholar and SCINCEDIRECT from 2001 to 2018; all the English language published studies were identified with the search keywords of, ankle reconstruction with limb lengthening in fibular hemimelia, fibular hemimelia and treatment of fibular hemimelia. Literature search database on PUBMED, Google Scholar and SCINCEDIRECT showed 193 studies. Results: Our search revealed 6 studies accounting for total of 74 patients included in the final analysis. Numbers of males were 24 patients and females were 30 patients. The mean age is 20.4 month, with average follow up time is 38.6 month. Each study was analyzed, and the following postoperative data were collected: outcomes, recurrence, dorsiflexion, planter-flexion, and complication. Conclusion: SUPER ankle procedure is a widely used technique with or without lengthening showing good results in correction of equinovalgus deformity of the ankle. Performing the reconstruction of the ankle at an earlier age plays a significant role in preventing recurrent foot deformities.