抄録
We report a 9-year-old girl with ankle deformity and leg length discrepancy (4.5 cm) caused by partial premature epiphyseal closure of the distal tibia after treatment for clubfoot. A malalignment test developed by Paley et al. was used to determine the degree of joint alignment and joint orientation. The mechanical medial distal tibial angle was 70°, the mechanical axis of the hip, knee, and ankle was collinear, and the orientation of the knee joint was normal. The center point of the plafond was also the apex of the deformity. To correct the varus and equinus deformity, acute correction was performed through a supramalleolar wedge osteotomy with the center of rotation at the level of the plafond. In order to minimize medial translation, an Ilizarov external fixator was used. To prevent recurrence of the deformity, the Langenskiöld procedure was performed with free fat graft interposition. To correct the leg length discrepancy, gradual mechanical distraction with an Ilizarov external fixator was used. The length of distraction reached 4.6 cm. The external fixation index was 63 days/cm. Although excellent leg length and alignment were obtained, the recurrence of deformity for the future must be carefully observed.
