Fibular lengthening procedure: treatment for lateral instability of the ankle caused by fibular insufficiency in Melnick-Needles syndrome.

Abstract

The Melnick-Needles syndrome (MNS) is a rare bone dysplasia with characteristic clinical and radiologic diagnostic findings. The diagnosis of MNS was made for the patient reported in this paper clinically and radiologic confirmation was done afterwards. Her left fibula was shorter than the right one. She had lateral insufficiency in her left ankle and could not bear weight on her left foot. A fibular length discrepancy of 2 cm was assessed. Her ankle-hindfoot score was 49 according to the American Orthopedic Foot and Ankle Society (AOFAS) clinical rating system for ankle and hindfoot. Simple fibular lengthening was performed with a unilateral external fixator. Two centimetres of fibular lengthening was obtained in 14 weeks. Her AOFAS ankle-hindfoot score was 82 after 27 months of follow-up. Ankle stability and plantigrade foot were achieved and the result was satisfactory.