MANAGEMENT OF FIBULAR HEMIMELIA (CONGENITAL ABSENCE OF FIBULA) USING ILIZAROV METHOD IN SULAIMANI

Background: Fibular hemimelia is the most common congenital deficiency of long bones. Therefore, it is characterized by a wide spectrum of manifestations ranging from mild limb length inequality to sever shortening with foot and ankle deformities and associated anomalies. Objectives: To evaluate the results of ankle and foot reconstruction and limb length equalization in patients with Fibular Hemimelia. Patients and Methods: A prospective study was carried out on 40 limbs in 32 patients with fibular hemimelia during the periods of March 2010 to January 2014. Male to female ratio was 24:8. Their age ranged at an average between 2-16 years (9 years). The reconstruction of ankle and foot was done. Also, the equalization of the limb was done also using Ilizarov frame. Results: The result of this study was assessed using the Association for the Study of Applications of Methods of Ilizarov (ASAMI) scoring system. Therefore, the final results were: Failure rate with 2 limbs 5%, Poor with 2 limbs 5%, Fair with 2 limbs 5%, Good with 8 limbs 20%, and Excellent with 26 limbs 65%. Conclusion: In conclusion, the Ilizarov method is an attractive alternative method used for the management of selected fibular hemimelic patients having three or more toes who are refusing amputation

Bone Transport of Tibia

This is a comparative study to evaluate the outcome of forty patients with bone loss in tibia using conventional external fixation device for group A while for group B using Ilizarov external fixator device each group consists of 20 patients, based on principles of distractive osteogenesis. Patients and methods: Forty patients with bone loss of 4 to 14 centimeters in tibia between April 2011 and April 2016 were treated, ages (15-65 years); female to male ratio was 6:34. The cause of defects in tibia was fracture due to road traffic accident (20 cases), bullet injury to leg (8 cases), gap nonunion (8 cases) and infected non unions(4 cases). They were divided into two groups each consists of 20 patients, conventional external fixator used for group A while for group B Ilizarov external fixator device was used with performing transverse corticotomy proximal or distal to the gap for both groups. Results: Evaluation of results was done according to Association for Study and Application of Methods of Ilizarov (A.S.A.M.I.) scoring system and it revealed that both functional and bony results were better in group B than group A. Conclusions: Fixation of the bone by Ilizarov frame gives more rapid union of the bone, less chance of pin tract infection and cosmetically more preferable because of smaller scar tissue of entry of K wires than Schanz pins. Prevention and treatment of equinus deformity and clawing of the toes can be done by extending the Ilizarov frame to correct them. In cases of severe soft tissue loss it is better to apply conventional external fixator as a provisional fixator till the soft tissue loss and swelling will be diminished