case_images: PMC6370161_01
case_images: Pre-operative clinical view of left affected leg. The medial soft tissue of left lower leg was extremely contracted.
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case_images: PMC6370161_01_medi-98-e14031-g001.jpg
case_images: F1
case_images: The movement range of ankle was 90  extension and 15 plantar flexion (Fig. 1; Video 1).
case_images: (A, B) Pre-operative X-Ray film of the affected leg.
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case_images: F2
case_images: A radiograph (Fig. 2A and B) showed the pelvis tilted to the left severely.
case_images: The first operation to release the medial soft tissue of left lower leg.
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case_images: PMC6370161_01_medi-98-e14031-g003.jpg
case_images: F3
case_images: Therefore, we used the combined external fixator to distract the contractures of medial soft tissue gradually (Fig. 3).
case_images: The second operation of fusion the superior tibiofibular joint and fibular osteotomy.
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case_images: F4
case_images: One month later, the dislocated fibular head was pulled down and fused with the proximal tibia by 2 screws; the fibular osteotomy was also performed to correct the hypertrophied and curved fibula (Fig. 4).
case_images: Clinical view with external fixator during the lengthening.
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case_images: F5
case_images: The patient accepted our suggestion, and the femur was distracted 2-month postoperative of fibular osteotomy in the second stage (Fig. 5).
case_images: Radiograph showing the bone regenerate in the (A) femur and (B) fibula.
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case_images: F6
case_images: After 6 months of the femur lengthening, the fibula was prolonged and the equinovarus deformity of foot was corrected at the same time (Fig. 6A and B).
case_images: (A, B) Post-operative clinical view of 5 years follow-up.
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case_images: F7
case_images: But the left lower limb was still 2 cm shorter than the contralateral limb (Fig. 7A and B). The left lower limb was still 2 cm shorter than the contralateral limb (Fig. 7A and B).
case_images: Post-operative Radiograph showing the MAD of affected lower limb. MAD = mechanical axis deviation.
case_images: medi-98-e14031-g008.jpg
case_images: PMC6370161_01_medi-98-e14031-g008.jpg
case_images: F8
case_images: (A-D) The active ROM of the affected knee and ankle in the 5 years post-operative.
case_images: medi-98-e14031-g009.jpg
case_images: PMC6370161_01_medi-98-e14031-g009.jpg
case_images: F9
case_images: The knee function was extension 0  and flexion 40 . The active ROM of ankle was normal (Fig. 9A-D; Video 2).