TIBIO-FIBULAR RELATIONSHIP IN PARALYSED LIMBS

Abstract

1. A survey of 112 cases of residual poliomyelitis with leg shortening of 2·5 centimetres or more is reported. 2. In eighty-seven patients paralysed in early infancy the fibular shortening was greater than the tibial shortening. 3. The absence of the normal "to and fro" motion of the fibula causes delay in the appearance of the fibular epiphyses and retards fibular development. 4. The shortening of the fibula in infancy causes deformity at the ankle, in the tibia itself and at the knee. 5. At the ankle the poorly developed lateral malleolus causes wedging of the lower tibial epiphysis and valgus at the ankle, which is often unstable. 6. At the knee progressive genu valgum is produced and in the tibia lateral torsion occurs. 7. The clinical significance of these deformities in relation to reconstructive procedures is stressed.