case_images: PMC11156992_01
case_images: (A) and (B) show ulceration and bony prominence over the right tibial stump prior to the operation. (C) The right tibia stump without any significant osseous growth after 2 years post-operation. (D) The pre-operative plain radiographs revealing excessive osseous growth over the distal tibia and fibula, with the growth almost penetrating through the soft tissue. (E) exhibits post-operative plain radiographs taken 2 years after the surgery, demonstrating the union of the fibula with the distal tibia and the absence of excessive osseous growth.
case_images: fsurg-11-1320661-g001.jpg
case_images: PMC11156992_01_fsurg-11-1320661-g001.jpg
case_images: F1
case_images: No skin ulceration, knee joint instability or terminal osseous overgrowth was observed during the 2-year follow-up period (Figure 1).
case_images: PMC11156992_02
case_images: (A) Illustrates the prominent distal right below-knee stump. (B) showcases the overgrowth of the distal tibia and fibula. (C) displays the post-operative image after the ipsilateral fibula transfer to the right knee stump. (D) exhibits the corresponding plain radiographs.
case_images: fsurg-11-1320661-g002.jpg
case_images: PMC11156992_02_fsurg-11-1320661-g002.jpg
case_images: F2
case_images: Physical examination revealed a prominent bone protrusion of approximately 3 cm at the end of the stump, making it difficult to fit into a prosthesis (Figure 2).
case_images: PMC11156992_03
case_images: (A) and (B) depict the patient's initial presentation with valgus deformity of the right knee and a prominent right below-knee stump. (C) shows the corrected valgus deformity of the right below-knee stump after the surgery. (D) displays preoperative plain radiographs revealing overgrowth of the distal tibia and fibula, as well as valgus deformity at the proximal tibia. (E) illustrates the closed wedge osteotomy performed on the proximal right tibia and the intramedullary splint created using the ipsilateral fibula.
case_images: fsurg-11-1320661-g003.jpg
case_images: PMC11156992_03_fsurg-11-1320661-g003.jpg
case_images: F3
case_images: To address both the deformity and overgrowth, corrective osteotomy of the proximal right tibia and transfer of the ipsilateral fibula were performed (Figure 3).
case_images: (A) and (B) are intraoperative photos showing the fibular head with the metaphyseal-diaphyseal end inserted into the tibial medullary canal, acting as an intramedullary end-cap. (C) displays the harvested ipsilateral fibula.
case_images: fsurg-11-1320661-g004.jpg
case_images: PMC11156992_03_fsurg-11-1320661-g004.jpg
case_images: F4
case_images: The fibula was snugly fit with the tibia, eliminating the need for additional fixation (Figure 4).