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Surgical technique for varus deformity correction of below-knee stump in a paediatric patient

Nik Abdul Adel, Nik Alyani and Abdul Razak, Ardilla Hanim and Sri Ramulu, S Suresh and Awang, Mohd Shukrimi (2023) Surgical technique for varus deformity correction of below-knee stump in a paediatric patient. Cureus Journal of Medical Science, 15 (8). pp. 1-5. ISSN 2168-8184

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Paediatric amputation is one of the treatment options for various indications, namely, trauma, infection, tumour and congenital problems, and some may be born with congenital problems. It differs from adult amputation as they have higher physical demands, and special complications may arise. Stump overgrowth by far is the commonest complication in paediatric transosseous amputation, while varus deformity of the tibia stump was reported sparsely in the literature. The growth discrepancy of the proximal tibia and fibula physis coupled with distal tibiofibular synostosis may have resulted in proximal migration of the fibula, which later resulted in varus deformity of the stump. This will cause difficulty in prosthesis fitting and lead to painful stumps due to the pressure at the abnormal bony prominence. We report a case of congenital limb deficiencies in a 12-year-old male who was treated with below-knee amputation (BKA) and experienced progressive varus deformity of the stump that caused pain during prosthetic wear, which interfered with his gait. He had a varus deformity of 15 degrees of the stump, distal tibiofibular synostosis and proximal migration of the fibula head. As the conservative management by modification of the prosthesis had failed, he underwent open wedge proximal tibia corrective osteotomy, division of the synostosis and reduction of the fibula head. The surgical intervention was successful in alleviating his problem. All efforts must be made to ensure optimum prosthetic fitting in paediatric amputation patients to maintain the patient’s daily lifestyle and activities.

Item Type: Article (Case Report)
Additional Information: 8342/106604
Uncontrolled Keywords: tibiofibular synostosis, corrective osteotomy, varus deformity, paediatric amputation, congenital limb deficiency
Subjects: R Medicine > RD Surgery > RD701 Orthopedics
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine
Kulliyyah of Medicine > Department of Department of Orthopaedics, Traumatology & Rehabilitation
Depositing User: Dr Nik Alyani Nik Abdul Adel
Date Deposited: 15 Sep 2023 10:05
Last Modified: 15 Sep 2023 10:05
URI: http://irep.iium.edu.my/id/eprint/106604

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