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Case 4: Tibial Lengthening, Deformity and Nonunion Correction

Written by: Dr F Birkholtz

J.D. was 8 years old when he presented to us from Angola. He had a bone infection previously which was treated effectively and his leg was saved. He was however left with 8cm of shortening, as well as a nonunion and a deformity in his tibia. He requested that we correct this.

           Click on image to enlarge  


Pre-operative X-ray

Unfortunately the Xray quality is fairly poor, but one can clearly see the shortening in the right tibia. Also visible is the plate and pin in the tibia left over from previous surgery. Behind the plate at the top, the bone was not healed. Lastly, one can clearly see the deformity of the right lower leg.

The Ilizarov Frame

This is JD a few weeks after his surgery. During surgery his plate was removed, the bone straightened and an Ilizarov fixator applied. The bone was also divided close to the ankle joint to allow gradual leg lengthening to his normal length.

X-ray during lengthening

An Xray during the lengthening phase of treatment. One can clearly see the gap where the bone is being lengthened. This will eventually fill up with strong, normal quality bone.

Final X-ray

This Xray shows a straight, united leg of normal length with good alignment. JD was extremely happy with his treatment and returned to Angola.