case_images: PMC11427399_01
case_images: (A,B) appearance at other hospitals after an injury. (C,D) One year after trauma healing the right foot showed deformity development, acquired flatfoot, and ankle fusion.
case_images: fsurg-11-1391384-g001.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g001.jpg
case_images: F1
case_images: After one year of recovery, the flap survived well, but due to the severe ankle joint injury and the absence of the medial longitudinal arch of the right foot, the child's right foot gradually developed into a deformity and he walked with a severe limp (Figure 1).
case_images: (A) The patient needed assistance to stand normally and was unable to touch the floor with his right heel, which needed to be elevated by 2 cm. (B) The patient's gait was lame and the right foot was in an externally rotated position.
case_images: fsurg-11-1391384-g002.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g002.jpg
case_images: F2
case_images: The child needs to be assisted or have a 2 cm thick plate on the bottom of the right foot to stand up flat on the ground (Figure 2A).
case_images: (A-C) preoperative 3D printing demonstrates the appearance of bone alignment in the affected foot. (D,E) Preoperative marking of the body surface was done according to the 3D print.
case_images: fsurg-11-1391384-g003.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g003.jpg
case_images: F3
case_images: (A,B) postoperative appearance after ankle release and six-axis external fixation of TSF, medial volume lengthening.
case_images: fsurg-11-1391384-g004.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g004.jpg
case_images: F4
case_images: Taylor bracket was attached and assembled with connecting rods. The first metatarsal was then fixed longitudinally with two 3.0 mm Kirschner wires, and the other 3.0 mm Kirschner wires were fixed to the dice bone with a unilateral extension brace (Figure 4).
case_images: (A-C) orthopedic appearance at two months postoperatively, with the ankle close to 90  of flexion and adequate volume in the medial column of the foot.
case_images: fsurg-11-1391384-g005.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g005.jpg
case_images: F5
case_images: After the first surgery, the child's drop foot and valgus deformity were corrected after two months of constant adjustments, and the missing space of the medial column of the foot was adjusted (Figure 5).
case_images: (A) Removed epiphyseal fibula head and articular tissue. (B) The two supplying vessels of the fibular head are anastomosed to the distal and proximal ends of the medial plantar artery under the microscope.
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case_images: PMC11427399_01_fsurg-11-1391384-g006.jpg
case_images: F6
case_images: (A-C) on review two months after surgery, the patient was able to stand on her own, with both shoulders and both iliacs isometric, and the appearance of the foot was corrected.
case_images: fsurg-11-1391384-g007.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g007.jpg
case_images: F7
case_images: Two months after the second surgery, we found that the child's standing posture was corrected, the length of the affected foot was equal to that of the healthy side, and the child could walk on his own, with occasional discomfort and no obvious pain (Figure 7).
case_images: (A-C) Two months postoperative x-ray showed that the internal fixation was in place and the medial column reconstruction was in good position.
case_images: fsurg-11-1391384-g008.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g008.jpg
case_images: F8
case_images: (A,B) comparison of grafted bone length in the second six months orthopantomogram (left) and eight months orthopantomogram (right): the first metatarsal train followed the patient's developmental growth by 5 mm.
case_images: fsurg-11-1391384-g009.jpg
case_images: PMC11427399_01_fsurg-11-1391384-g009.jpg
case_images: F9