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J Bone Joint Surg Br ; 93(6): 839-43, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21586787

RESUMO

Survivors of infantile meningococcal septicaemia often develop progressive skeletal deformity as a result of physeal damage at many sites, particularly in the lower limb. Distal tibial physeal arrest typically occurs with sparing of the distal fibular physis leading to a rapidly progressive varus deformity. There have been reports of isolated cases of this deformity, but to our knowledge there have been no papers which specifically describe the development of the deformity and the options for treatment. Surgery to correct this deformity is complex because of the patient's age, previous scarring and the multiplanar nature of the deformity. The surgical goal is to restore leg-length equality and the mechanical axis at the end of growth. Surgery should be planned and staged throughout growth in order to achieve the best functional results. We report our experience in six patients (seven ankles) with this deformity, who were managed by corrective osteotomy using a programmable circular fixator.


Assuntos
Articulação do Tornozelo/cirurgia , Deformidades Articulares Adquiridas/cirurgia , Infecções Meningocócicas/complicações , Osteotomia/métodos , Sepse/complicações , Adolescente , Criança , Pré-Escolar , Fixadores Externos , Feminino , Lâmina de Crescimento/crescimento & desenvolvimento , Lâmina de Crescimento/cirurgia , Humanos , Deformidades Articulares Adquiridas/microbiologia , Desigualdade de Membros Inferiores/microbiologia , Desigualdade de Membros Inferiores/cirurgia , Masculino , Osteotomia/efeitos adversos , Tíbia/crescimento & desenvolvimento , Resultado do Tratamento
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