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Correction of limb length discrepancy after tibialization of the fibula

INTRODUCTION Management of large segmental defects of the tibia remains a therapeutic challenge despite innovation of many new techniques. Various surgical options that have been used to manage such defects include, the Papineau procedure, allograft reconstruction, distraction osteogenesis, vascularized or nonvascularized contralateral fibular transfer, tibiofibular synostosis, and centralization of ipsilateral fibula (tibialization of fibula). Each of these techniques has its specific indications, advantages and disadvantages with variable success rates. Tibialization of the fibula has been used to successfully manage such large tibial segmental defects. However, even after successful “tibialization” of the fibula, limb-length discrepancy with growth remains a challenging problem especially in the pediatric age group. Although shortening of the tibia due to various pathologies is successfully managed by lengthening using Ilizarov’s ring fixator, we report this case of lengthening of a tibialized fibula which has not been reported earlier in available published literature. Informed consent was obtained by the parents of the patient.