Weinstein Lovell and Winters Pediatric Orthopaedics 7e

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CHAPTER 30  |  The Child with a Limb Deficiency

(35) (Figs. 30-6 to 30-8). They correlated the classification with the discrepancy in length and recommended treatment on the basis of the classification. Given the large variation in the different aspects of fibular deficiency, including the

­parents’ desire, it remains unlikely that classifications based on radiographic appearance of the fibula will provide anything more than a rough guide and a method of comparing patients in different reports.

A

B

C

D

FIGURE 30-6. A,B : The radiographs of a 3-month-old boy with type 1a fibular deficiency of the Achterman and Kalamchi classification. The proximal fibula is short. C,D : AP and lateral radiographs of the same patient at the age of 7 years, 6 months. The shortening of the fibula is more apparent and the ball-and-socket ankle joint is easily seen. E : The foot at the same age, with the lateral two rays missing. F : At 13 years of age, the leg was lengthened by 7 cm.

E

F