Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector64256710.17816/medjrf642567AIOUVNCase reportsКлинический случайResearch ArticleIlizarov method in the treatment of a child with severe congenital fibular hemimeliaМетод Илизарова при лечении ребёнка с врождённой гемимелией малоберцовой кости тяжёлой степениhttps://orcid.org/0009-0003-1235-97588659-1840ImomovShokhbek A.ИмомовШохбек Азаматович
Russian Federation

MD

shoh777123@gmail.comhttps://orcid.org/0000-0003-0883-96634940-7227LeonchukSergey S.ЛеончукСергей Сергеевич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

leon4yk@mail.ruhttps://orcid.org/0009-0007-8700-45201142-0445VorobyevaAlena N.ВоробьеваАлена Николаевна
Russian Federation

MD

alena_vorobeva_87@list.ruNational Medical Research Centre for Traumatology and Orthopedics named after academician G.A. IlizarovНациональный медицинский исследовательский центр травматологии и ортопедии имени академика Г.А. Илизарова04062025110620253133073150512202430012025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://medjrf.com/0869-2106/article/view/642567

Introduction: The treatment of patients with severe (aplasia) congenital fibular hemimelia (CFH) remains a major clinical challenge. In many cases, these patients are offered amputation or receive no medical attention at all. This article aims to demonstrate the effectiveness of our approach using the Ilizarov method in patients with CFH, based on clinical and radiographic findings as well as contemporary scoring systems and questionnaires.

Clinical case description: An analysis was conducted of the treatment of a child with severe CFH (fibular aplasia), considering clinical and radiological data along with modern assessment criteria and scoring systems. Due to a 10 cm shortening of the affected limb, the child’s family was offered only amputation by local specialists. We performed bifocal lengthening and deformity correction of the right lower leg and foot using the Ilizarov apparatus. The evaluation criteria for the tibial lengthening stage included the external fixation index, the amount of lengthening (cm, %), the results according to the Lascombes classification, and the scoring system of the Association for the Study and Application of the Method of Ilizarov. Ambulatory function was assessed using the Gillette questionnaire. Functional outcome was also evaluated according to the Association for the Study and Application of the Method of Ilizarov score. This method enabled safe and reliable lengthening, reconstruction, and preservation of the affected limb as an alternative to amputation. Long-term follow-up confirmed the stability of the treatment outcome.

Conclusion: The outcome of treating a child with severe CFH demonstrated the high effectiveness of our approach, which should be considered a treatment option in similar cases.

Обоснование. Лечение пациентов с врождённой гемимелией малоберцовой кости (врождённой малоберцовой гемимелией, ВМГ) тяжёлой степени (аплазией) на сегодняшний день является сложной задачей. Нередко таким пациентам предлагается выполнение ампутации или они вовсе остаются без внимания. В данной статье поставлена цель показать эффективность нашего подхода с применением метода Илизарова при лечении пациентов с ВМГ как по результатам клинико-рентгенологического исследования, так и согласно данным современных балльно-оценочных шкал и опросников.

Описание клинического случая. Проведён анализ лечения ребёнка с ВМГ тяжёлой степени (аплазия) с учётом клинико-рентгенологической картины, а также современных критериев и оценочных шкал. Ввиду укорочения больной конечности на 10 см семье данного ребёнка по месту жительства предлагали лишь ампутацию. Нами проведены оперативное билокальное удлинение и коррекция деформации правой голени и стопы с использованием аппарата Илизарова. Критериями оценки этапа удлинения голени являлись индекс внешнего остеосинтеза, величина удлинения (см, %), результаты по классификации P. Lascombes и шкале Ассоциации по изучению и применению метода Илизарова. Способность ходьбы у ребёнка исследовали с использованием опросника Gillette. Функциональный результат оценивали согласно шкале Ассоциации по изучению и применению метода Илизарова. Данный метод позволил безопасно и надёжно удлинить, реконструировать и сохранить больную конечность пациента вместо ампутации. В отдалённом периоде наблюдения результат лечения сохранялся.

Заключение. Результат лечения ребёнка с ВМГ тяжёлой степени показал высокую эффективность нашего подхода, который рекомендуется рассматривать как вариант лечения в подобных случаях.

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