Longitudinal overgrowth of the femur stimulated by short-leg ambulation in unilateral partial tibia hemimelia.

In the treatment of unilateral partial tibia hemimelia, complications from extensive lengthening to correct the marked shortening and recurrent failures of foot reconstructions do not allow limb salvage. Treatment by amputation with prosthetic replacement predominates. Very often, however, amputation is rejected by patients. A case we treated in infancy by complete reconstruction without lengthening walked full weight bearing on the short leg. Twelve years later, the ipsilateral femur manifested 6 cm overgrowth to reduce the shortening. Stimulation of accelerated growth in the partial tibia hemimelia limb by axial-directed stress of short-leg ambulation is suggested by this report, and its implication for enduring limb salvage is discussed.