Three-dimensional correction of fibular hemimelia using a computer-assisted planning : technical report and literature review


fibular hemimelia ; hindfoot deformity ; computer assisted planning ; corrective osteotomy

Published online: Feb 13 2021

Arne Burssens, Hannes Vermue, Maxwell Weinberg, Aline Van Oevelen, Sophie Lauwagie, Malcolm Forward, Frank Plasschaert

From the Orthopaedic Department of the University Hospital of Ghent, Belgium and University Hospital of Utah, Salt Lake City, USA.


The purpose of this study is to investigate a stepwise approach to translate the principles of deformity correction from 2D plain radiographs to a 3D computer assisted pre-operative planning (CAP), when treating a complex case of fibular hemimelia.

Computed tomography slices were used to perform a 3D reconstruction of the deformity. CAP determined the different axes and apex of deformity based on geometrical functions of the software. The obtuse angle was computed and used to determine the concomitant osteotomy angle. An additional review of the literature was performed, allowing comparison towards the current treatment approaches.

The pre- and post-operative clinical and radiographic follow up is reported. The computer assisted planning was applicable in a complex fibular hemimelia deformity. The literature review demonstrated no previous use of a 3D computer assisted planning.

This case report provides a feasible and effective method to convert the principles of deformity planning from a 2D to a 3D setting. The added value of this technique for clinical practice should be confirmed in further prospective studies.

Level of evidence : Level V, Case report