We reviewed the results of limb salvage treatment in four children (five extremities) who had congenital fibular hemimelia and were managed between 1981 and 2001. The age at the time of the first visit ranged from eight days after birth to nine years and eight months, and the follow-up period ranged from two years and ten months to nineteen years. Three extremities showed complete absence of fibula, and two showed proximal absence with distal anlage. Posterior release of the ankle was performed on four extremities to correct the pes equinus deformity. Tibial lengthening was performed on three extremities, and was repeated on two extremities. However, common complications were seen such as medial bending deformities of the tibia and lengthening difficulties because of excessive tightness of soft tissues. Three children showed good ambulation with or without AFO and one showed poor walking at final follow-up. We think this form of treatment is an attractive alternative to early amputation.
