BACKGROUND: @entity942 of the fibula is the most common lower extremity @entity942 , with a broad spectrum of severity and subsequent reconstructive treatment. Published classification schemes do not accurately predict reconstructive treatment currently in practice. METHODS: We reviewed all medical records of @entity1 with a dominant deformity of @entity3030 who were managed at our institution between 1971 and 2005. We assessed the impact of limb-length inequality, @entity5109 , bilateral extremity involvement, and extent of fibular preservation on the treatment of the @entity4218 . RESULTS: One hundred and four @entity1 (including twenty-two with bilateral @entity3030 ) with 126 affected extremities had adequate radiographs to be included in the study. Femoral shortening was noted in seventy (85.4%) of eighty-two @entity1 with unilateral limb involvement. Limb-length discrepancy prior to any treatment remained proportional in forty-seven (82.5%) of fifty-seven @entity1 during an average duration of follow-up of ten years and ten months (range, two years to fifteen years and six months). Limb salvage with foot preservation was deemed feasible in thirty-eight (97.4%) of thirty-nine five-rayed feet, thirty (81.1%) of thirty-seven four-rayed feet, twenty (48.8%) of forty-one three-rayed feet, and one of nine feet having fewer than three rays. Twenty-two (41.5%) of fifty-three limbs with an absent or vestigial fibula were not treated with amputation. Of the twenty-two @entity1 with @entity3030 , twelve (54.5%) had preservation of both feet, three (13.6%) had unilateral amputation, and seven (31.8%) had bilateral amputation. CONCLUSIONS: We propose a simplified classification for @entity3030 based on the clinical status of the foot and the magnitude of limb shortening as a percentage of the contralateral limb on radiographs. This classification may be effectively applied in infancy to allow the physician and family to anticipate the extent of @entity85 and to estimate the amount of treatment required to reconstruct this @entity4218 . This system more accurately predicted the management of @entity1 with @entity3030 who were managed at our institution over the past three decades .

XXXX : a review of thirty years' experience at one institution and a proposed classification system based on clinical deformity.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5109 :: ('MESH:D005530', 'Disease') :: ['foot deformity'] @entity3030 :: ('MESH:D020427', 'Disease') :: ['fibular deficiency', 'bilateral fibular deficiency', 'congenital fibular deficiency'] @entity4218 :: ('MESH:D017880', 'Disease') :: ['limb deficiency', 'limb deformity'] @entity85 :: ('MESH:D009140', 'Disease') :: ['deformity at maturity'] @entity942 :: ('MESH:D003677', 'Disease') :: ['congenital deficiency', 'Congenital longitudinal deficiency']
@entity3030 :: (MESH:D020427,Disease) :: ['Congenital fibular deficiency']
