Treatment of hemimelias of the lower extremity. Long-term results.

We used contemporary methods, including early surgical intervention (usually amputation) and prosthetic rehabilitation, to treat tibial or fibular hemimelia in thirty-three patients (forty-four limbs); twenty-four patients (twenty-nine limbs) had adequate follow-up, and their cases are reported here. After an average length of follow-up of sixteen years, all except two of the patients had an excellent or a good result. No patient had migration of the heel pad or a slough or infection of the skin, and only one patient needed a second operation. The Brown procedure was done on three limbs (two patients), but it always had to be supplemented by a corrective operation. We concluded that early surgical treatment and prosthetic rehabilitation yield an excellent result, not only for the short term but also for the long term.