limb length discrepancy and deformity correction

Congenital fibular deficiency (CFD) is characterized by a wide spectrum of manifestations ranging from mild limb length inequality (LLI) to severe shortening, with foot and ankle deformities and associated anomalies. The etiology of CFD remains unclear. Treatment goals are to achieve normal weight bearing, a functional plantigrade foot, and equal limb length. The recent Birch classification system has been proposed to provide a treatment guide: the functionality of the foot, LLI, and associated anomalies should be taken into account for decision-making...

Distraction osteogenesis has been used for more than 50 years to address limb-length discrepancy and deformity. Intramedullary fixation has been used in conjunction with external fixation to decrease the time in the external fixator and prevent deformity and refracture. A new generation of motorized intramedullary nails is now available to treat limb-length discrepancy and deformity. These nails provide bone fragment stabilization and lengthening with reliable remote-controlled mechanisms, obviating the need for external fixation...