{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:30:38Z","timestamp":1788910238241,"version":"build-2803163510"},"reference-count":17,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Management of ankle deformity and instability remains a challenge in patients with severe fibular hemimelia (FH). This study aims to evaluate the long-term effectiveness of lateral malleus reconstruction using the fibular anlage in correcting ankle malalignment and preventing the recurrence of deformity following leg lengthening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Ten patients (age: 3.3\u2009years, 0.8\u20137.7) with a severe FH, equino-valgus foot deformity, ankle instability, and tibial bowing underwent tibia and ankle realignment and lateral malleolus reconstruction. Afterward, all patients underwent tibial lengthening, and the mean lengthening was 9.9\u2009cm (5.0\u201316.5). Foot and ankle alignment was evaluated clinically and radiographically before surgery, postoperatively, and at a follow-up (10.0\u2009years, 9.2\u201311.7). Recurrences, additional procedures, and complications were analyzed. Quality of life was assessed using the Limb Deformity-Scoliosis Research Society (LD-SRS) questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At the last follow-up, all patients present neutral heel position or slight valgus (three patients 5\u00b0 and one patient 10\u00b0). No additional procedures were performed except medial malleus temporary epiphysiodesis in two patients. The foot was plantigrade in six patients, presented equinus 10\u00b0 in two and 20\u00b0 in two, due to equinus, supra-malleolar osteotomy was performed in three patients. Significant improvement of radiological alignment was found and maintained in all parameters. The mean LD-SRS score was 3.78 at follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Lateral malleolus reconstruction provided good clinical, radiological, and functional outcomes. Due to the tendency for recurrence, additional procedures may be necessary.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>IV<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18632521261432859","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T06:45:51Z","timestamp":1775285151000},"page":"349-358","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Lateral malleolus reconstruction for fibular hemimelia as a prevention of foot deformity recurrence following tibial lengthening\u2014A long-term analysis"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-0243","authenticated-orcid":false,"given":"Milud","family":"Shadi","sequence":"first","affiliation":[{"name":"Poznan University of Medical Sciences, Department of Spine Disorders and Pediatric Orthopedics, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5702-4933","authenticated-orcid":false,"given":"Piotr","family":"Janusz","sequence":"additional","affiliation":[{"name":"Poznan University of Medical Sciences, Department of Spine Disorders and Pediatric Orthopedics, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0211-771X","authenticated-orcid":false,"given":"Eliza","family":"Kortus","sequence":"additional","affiliation":[{"name":"Poznan University of Medical Sciences, Department of Spine Disorders and Pediatric Orthopedics, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0810-9361","authenticated-orcid":false,"given":"Tomasz","family":"Kotwicki","sequence":"additional","affiliation":[{"name":"Poznan University of Medical Sciences, Department of Spine Disorders and Pediatric Orthopedics, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/children8060467"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-22-04-246"},{"key":"e_1_3_2_4_2","first-page":"178","article-title":"Ankle reconstruction in fibular hemimelia: new approach","volume":"13","author":"Hefny H","year":"2017","unstructured":"Hefny H, Elmoatasem EM, Mahran M, et al. Ankle reconstruction in fibular hemimelia: new approach. HSS Journal\u00ae Musculoskelet J Hosp Spec Surg 2017; 13: 178\u2013185.","journal-title":"HSS Journal\u00ae Musculoskelet J Hosp Spec Surg"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-016-0790-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00683"},{"key":"e_1_3_2_7_2","first-page":"27","article-title":"Bending osteotomy through the distal tibial physis in fibular hemimelia for stable reduction of the hindfoot","volume":"12","author":"Exner GU.","year":"2003","unstructured":"Exner GU. Bending osteotomy through the distal tibial physis in fibular hemimelia for stable reduction of the hindfoot. J Pediatr Orthop Part B 2003; 12: 27\u201332.","journal-title":"J Pediatr Orthop Part B"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11751-012-0129-4"},{"key":"e_1_3_2_9_2","first-page":"265","article-title":"Malleolus externus Plasty for joint reconstruction in fibular aplasia: preliminary report of a new technique","volume":"11","author":"Weber M","year":"2002","unstructured":"Weber M, Siebert CH, Goost H, et al. Malleolus externus Plasty for joint reconstruction in fibular aplasia: preliminary report of a new technique. J Pediatr Orthop B 2002; 11: 265\u2013273.","journal-title":"J Pediatr Orthop B"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001012"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2019.07.008"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002876"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.6.210015"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-025-08835-1"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4103\/2455-3719.190710"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200007000-00003"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001510"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.21608\/ejhm.2019.33798"}],"container-title":["Journal of Children's Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/18632521261432859","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/18632521261432859","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/18632521261432859","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:00:55Z","timestamp":1785567655000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/18632521261432859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,3]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/18632521261432859"],"URL":"https:\/\/doi.org\/10.1177\/18632521261432859","relation":{},"ISSN":["1863-2521","1863-2548"],"issn-type":[{"value":"1863-2521","type":"print"},{"value":"1863-2548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,3]]}}}