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- W2060155102 abstract "T umors of the distal part of the fibula necessitating resection pose a problem because of the need to reconstruct a stable ankle joint and to obtain coverage of this area. Standard textbook solutions include simple resection of the distal aspect of the fibula including the lateral malleolus, as described by Carnesale1 and later by Norman-Taylor et al.2, and resection of the distal part of the fibula with reconstruction of the lateral malleolus with use of the fibular head, as described by Carrell3, Herring et al.4, and de Gauzy et al.5. An allograft reconstruction has also been described6, as has reconstruction with an iliac crest bone graft7. Other possible techniques, albeit less desirable, are ankle arthrodesis and amputation. Although the textbook techniques are considered to be classics, not many reports have detailed their use and results2-5,8-12.These methods, at least theoretically, have a number of drawbacks. In distal fibular resection without reconstruction, the stabilizing effect of the lateral malleolus is lost. Soft-tissue reinforcement, even when it is possible, cannot fully compensate for the loss of stability13. Thus, the ankle may collapse into valgus and may be unstable in varus. Conversely, when the mortise is reconstructed with use of a proximal fibular (head) graft, the lateral collateral ligament of the knee is affected and the peroneal nerve is endangered14,15. Additionally, the fibular head is not totally congruent with the lateral articular surface of the talus and provides no stabilizing ligament attachments. Ankle arthrodesis might solve the problems of instability, but it limits the ability to walk. Amputation is reserved as a last resort for patients in whom limb-sparing is not feasible.We describe a …" @default.
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- W2060155102 date "2005-04-01" @default.
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- W2060155102 title "Lateral Malleolar Reconstruction After Distal Fibular Resection" @default.
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- W2060155102 doi "https://doi.org/10.2106/jbjs.d.02539" @default.
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