You’re in the park observing your child struggling to keep pace with their age. As other children run and play, your child limps behind—one foot twisting awkwardly outward & shorter. Other people look over, some with interest, others with concern.
You force a smile, but your heart hurts. You know the diagnosis, treatment, symptoms —fibular hemimelia—but now what? How do you give your child the best opportunity to walk, run, and live life fully?
For the parents of a child with fibular hemimelia, this situation is personally familiar. It’s not just a physical variation—it’s a day-to-day struggle with uncertainty, fear, and the desperate need to know. But hope exists.
One of the most effective solutions is the SUPERankle procedure, a unique surgery to address complicated ankle and foot deformities and provide children with the gift of assured mobility.
Understanding the SUPERankle Procedure
The SUPERankle procedure is the abbreviation for “Systematic Utilitarian Procedure for Extremity Reconstruction of the ankle area.” Dr. Dror Paley initially developed the SUPERankle procedure as a solution for reconstructing extremely deformed ankles and feet due to fibular hemimelia.
The result achieved is an on-the-job functional, flat-on-the-ground foot, and walking will be simple and involve a normal-like gait.
This procedure is normally illustrated to children at the age of 12 to 18 months to enable normal growth and subsequent follow-up limb lengthening surgery. Unlike other procedures that repair only half of the deformity, the SUPERankle procedure repairs both bony as well as soft tissue deformities with a more robust outcome.
Objectives of the Treatment
The ultimate long-term goal of the SUPERankle procedure is to stabilize and reconstruct the ankle joint, align the limb, and allow the child to walk unaided. The procedure also seeks to:
Make the eradication of foot and ankle instability simpler
- Avoid recurrence of deformity
- Provide the correct platform for secondary limb lengthening surgery
- Minimize amputation or more significant surgery frequency
Lastly, the long-term goal is for a child to have foot and leg anatomy that will enable daily living, mobility, and quality of life.
Overview of the SUPERankle Surgical Procedure
SUPERankle surgery is a complicated procedure that involves multiple steps of surgery:
- Excision of the Fibular Anlage: If a residual cartilage of the fibula (fibular anlage) exists, this is removed. This eliminates any potential future tethering or deformity of the tibia.
- Osteotomy of the Tibia: A planned cut of the tibia bone is done to correct alignment issues, particularly valgus (lateral angulation) deformities. This permits re-establishment of the weight-bearing axis.
- Ankle and Foot Reconstruction: Muscles, tendons, and ligaments are stretched or re-aligned to facilitate the normal functioning and movement of the ankle. In most cases, the bones of the foot are remodeled or reconstructed.
- Internal Fixation: Plates and screws are used to hold the corrected bones in their proper position. They can be taken out later depending on the healing and growth of the patient.
- Post-Surgical Rehabilitation: Physical therapy is required following the procedure. It strengthens, balances, mobilizes, and maintains the corrected architecture.
Advantages of the SUPERankle Procedure
- Global Correction: The SUPERankle procedure corrects bony and soft tissue deformities.
- Functional Outcome: Children predominantly have flat, stable feet with normal weight-bearing function.
- Early Mobility: Early procedure completion permits better muscle development and ambulation.
- Permits Limb Lengthening: Once a stable foot and ankle is achieved, additional limb lengthening is safer and more specific.
Will Foot and Ankle Deformities Recur?
The second most frequent question from parents is whether deformities will or will not recur following surgery. Recurrence is indeed possible in some patients due to growth or under-correction. Recurrence is created by
- Growth Spurts: As the patient ages, the earlier corrected deformities will recur due to unequal bone growth.
- Residual Deformities: If the primary surgery does not fully correct the underlying defect, the ankle and foot will continue to deform.
- Poor Rehabilitation: Not visiting physical therapy or following up will lead to complications or recurrence.
Occasionally, follow-up with an orthopedist is necessary. At some point in the future, revision surgeries can be performed periodically to preserve function and alignment.
What to Expect After the Procedure
Healing after the SUPERankle surgery varies in each child. The child must wear a cast or brace to stabilize healing bones. Physical therapy is initiated a few weeks after the surgery to acquire motion. Most children return to regular daily activity in a few months, but recovery takes a year.
Parents usually remark on dramatic improvement in play, walking, and social interaction. Psychological dividends from restored mobility are also considerable.
Long-Term Perspective
Patients treated with the SUPERankle procedure have outstanding long-term outcomes. Improved alignment and function lead to increased activity at school and in activities. The method is also a bridge to future limb lengthening, as needed, to prevent amputation or prosthetic use.
Eventually, some of the children will require further surgery, especially at growth spurts. These are less aggressive and are meant to maintain the results of the SUPERankle surgery.
Key Takeaways
The SUPERankle surgery is revolutionary for children with fibular hemimelia.
- It treats bone and soft tissue deformities to create a functioning, stable foot.
- Early treatment yields better results and allows for natural growth.
- Although recurrence is inevitable, this can be managed with follow-up.
- The operation greatly enhances the child’s mobility, confidence, and overall well-being.
Conclusion
Should your child be diagnosed with fibular hemimelia, extra attention is the order of the day. Trishla Ortho in India is a world-renowned pediatric orthopedic and neurorehabilitation care centre. Dr. Jitendra Jain’s staff at Trishla Ortho are specialists in treating complicated congenital conditions like fibular hemimelia and have performed quite a number of successful SUPERankle surgeries.
Trishla Ortho offers multi-specialty treatment using modern surgery, physical therapy, and post-recovery. By offering tailored care, every child receives the personalized care they truly deserve to reach their potential.
Schedule an appointment at Trishlaortho to learn how they can help your child recover from fibular hemimelia today. Your child’s journey to increased mobility and a better tomorrow starts here.
