Lower Limb Deformities: Deformity Correction and Function Reconstruction

Preface
	First, the Origin of the Qin Sihe Orthopedic Surgery
	Second, Dr. Qin Carried Out Excessive Surgery in the Cold Hei Long Jiang Province
	Third, Qin Sihe Entered Beijing to Set Up a Physical Disability Correction Center
	Fourth, Qin Sihe Took the Lead in Studying and Introduced the Ilizarov Method from Russia to China
	Fifth, Qin Sihe Has Created a Convenient and Efficient “Individualized Diagnosis and Technical Route”
	Sixth, the Establishment of Case Database for Orthopedic Surgery
	Seventh, Qin Sihe Became Acquainted with Western Orthopedics Circles
	Eighth, the Important Time Nodes
	Ninth, Dr. Qin Sihe’s Gift to the World Orthopedics Academia
Informative Abstract
Disclosure
Acknowledgment
Contents
1: Introduction
	1.1	 Limb Deformity and Dysfunction
		1.1.1	 General Situation of People with Limb Dysfunction in China
		1.1.2	 Current Situation of Orthopedic Surgery in China
		1.1.3	 The Origin, Formation, and Development of Qinsihe Orthopedic
	1.2	 Basic Surgical Technique
		1.2.1	 Soft Tissue Release
		1.2.2	 Bony Osteotomy
		1.2.3	 Tendon Transfer
			1.2.3.1	 Relationship Between Immobilization and Exercise After Tendon Transposition
			1.2.3.2	 The Following Factors Must Be Considered in Tendon Transfer
		1.2.4	 Arthrodesis
		1.2.5	 Lengthening and Equalization for Lower Limb
		1.2.6	 Qinsihe Plaster Method for Lower Limb Deformity
	1.3	 The Art of Minimally Invasive Surgery
		1.3.1	 Surgical Skill
		1.3.2	 Art of Surgery
		1.3.3	 Relation of Surgical Speed and Quality
		1.3.4	 Which Factors Make the Surgery Faster and Better?
			1.3.4.1	 Strategic Element: Master the Wisdom of Winning
			1.3.4.2	 Tactical Elements: Surgeon’s Martial Arts
			1.3.4.3	 The Magical Use of Conventional Orthopedic Instruments, Rarely Use X-Ray Examination During Surgery
		1.3.5	 Clinical Application of Qinsihe Mini-invasive Surgery
			1.3.5.1	 Main Application
			1.3.5.2	 Special Surgical Instruments
			1.3.5.3	 Suggestions for Subcuticular Releasing of Tendon and Membrane
			1.3.5.4	 Indications and Clinical Application of Mini-invasive Technique
		1.3.6	 Rational Application of Tourniquet
	1.4	 Preoperative Examination
		1.4.1	 Lower Extremity Deformity Checklists and Records
		1.4.2	 Preoperative Examination
		1.4.3	 Physical Examination
		1.4.4	 Lower Limb Deformity Surgical Treatment Evaluation Procedure
	1.5	 Surgical Indications and Expected Outcomes
		1.5.1	 Surgical Indications
		1.5.2	 Purpose and Outcome of Lower Limb Orthopedic Surgery
		1.5.3	 The Patients Should Undergo Surgery as Soon as Possible
		1.5.4	 Surgical Goal Designing
	1.6	 Advantages of Surgical Treatment of Lower Extremity Deformity
	1.7	 Surgical Decision Making
		1.7.1	 Principle of Lower Limb Surgery
		1.7.2	 How to Make a Correct Surgical Plan
		1.7.3	 Methods for Decision Making
		1.7.4	 How to Make the Surgery Successful?
	1.8	 Principles of Deformity Correction and Functional Reconstruction of Lower Limb
		1.8.1	 5P Medical Model
		1.8.2	 28-Word Clinical Working Policy
		1.8.3	 “1-2-3 Principle”
	1.9	 Postoperative Management and Functional Exercise
		1.9.1	 Simple Soft Tissue Surgery
		1.9.2	 Single Bone Surgery or Concurrent with Soft Tissue Surgery
		1.9.3	 Combined Surgery for Lower Extremity Deformities
		1.9.4	 The Surgery Fixed with Internal Fixation
		1.9.5	 The Surgery Fixed with Internal and External Fixation
		1.9.6	 The Surgery Performed in Elderly People
		1.9.7	 Deformity Correction of the Knee
		1.9.8	 The Surgery for Foot and Ankle Deformity
		1.9.9	 Matters Needing Attention
		1.9.10	 An Example Is Given to Illustrate Postoperative Management (Fig. 1.34)
	1.10	 The Enlightenment of Darwin’s Theory of Evolution on the Limb Reconstruction
		1.10.1	 Why There Are So Many Complicated Lower Limb Deformities and Diseases?
		1.10.2	 Why Can Distraction Osteogenesis Cure So Complex Lower Limb Deformity?
		1.10.3	 There Are Two Different Kinds of “The Whole” in the Objective World
		1.10.4	 Commonalities of Life Organizations
		1.10.5	 Conclusion
	1.11	 Qinsihe Natural Reconstruction Theory
		1.11.1	 Background
		1.11.2	 Connotation
		1.11.3	 Clinical Practice
		1.11.4	 The Result of Violating the Laws of Nature
		1.11.5	 From the Wolff Law to the Orthopedics “Natural Reconstruction”
		1.11.6	 The Relationship Between Wolff’s Law, Ilizarov Technique, and “Orthopedics Natural Reconstruction” Theory (Figs. 1.49 and 1.50)
		1.11.7	 Limb Ecological Reconstruction and Stress Control
			1.11.7.1	 The Occurrence of Limb Morphology and Function Is Related to Stress
			1.11.7.2	 The Background of Human Evolution
			1.11.7.3	 Stress Control Is the Basic Way of Limb Reconstruction
			1.11.7.4	 Natural Reconstruction Is the Ecological Reconstruction of the Limbs
			1.11.7.5	 External Fixation Is the Simplest and Most Effective Tool for Implementing External Stress Control
		1.11.8	 The Working Policy of Orthopedic Department
		1.11.9	 “One Walk, Two Lines, Three Balance” Guiding Principles of Lower Limb Orthopedic Reconstruction
	References
2: The Database of 34,459 Cases
	2.1	 Basic Data
	2.2	 The Formation of Database
		2.2.1	 40 Years’ Accumulation
		2.2.2	 Patient’s Information Form
	2.3	 Statistics of 32,659 Cases of Lower Limb Reconstruction
	2.4	 Causes of Orthopedic Diseases
		2.4.1	 The Disease Types Can Secondary to Limb Deformities
		2.4.2	 Top 20 Diseases in Qinsihe Orthopedics Institute
	2.5	 Surgical Method Analysis
		2.5.1	 There Are More Than 200 Kinds of Surgical Method in Qinsihe Orthopedics Institute, the Data as Follows
		2.5.2	 The Top 50 of Surgical Method
	2.6	 Innovation and Application of Orthosis
		2.6.1	 Innovative Application of Orthosis
		2.6.2	 Application of Orthosis in Qinsihe Orthopedics Institute
	2.7	 Statistical Analysis of Follow-Up Results of Lower Limb Surgery
		2.7.1	 The Data of 451 Cases Those Were Followed Up More Than 2 Years
		2.7.2	 The Data of 1078 Cases of Lower Extremity Deformity
		2.7.3	 The Data of 86 Cases of Cerebral Palsy Sequela Underwent Lower Limb Surgery
		2.7.4	 The Data of 227 Cases of Poliomyelitis Sequela Underwent Lower Limb Surgery
		2.7.5	 Long-Term Follow-Up Results of the Patient Due to Poliomyelitis Sequelae
		2.7.6	 The Data of 77 Cases with Lower Limb Deformity Due to Post-traumatic Sequela
		2.7.7	 Lower Limb Reconstruction Postoperative Evaluation Scale
3: Application of the Ilizarov Technique
	3.1	 Ilizarov Technique in China
		3.1.1	 Introduction, Transformation, and Development
		3.1.2	 Limb Deformity and Function Reconstruction Under Stress Control
	3.2	 Application of Skeletal External Fixation in Qinsihe Orthopedics
	3.3	 How to Get the Optimized Combination of Ilizarov Technology and Qin Sihe Orthopedic Surgery?
		3.3.1	 The Protocols of Clinical Practice
		3.3.2	 The Optimization Combination Principle of Qin Sihe Method and Ilizarov Technology
	3.4	 Ilizarov Technique for the Treatment of Severe Flexion Deformity of the Knee
		3.4.1	 Etiology and Clinical Manifestations
			3.4.1.1	 Etiology
			3.4.1.2	 Clinical Manifestations
		3.4.2	 Preoperative Preparation
		3.4.3	 Surgical Processing
		3.4.4	 Postoperative Managements
		3.4.5	 Typical Cases
	3.5	 Ilizarov Technique for the Treatment of Orthopedic Incurable Diseases
		3.5.1	 The Scope of Incurable Diseases of Orthopedics
		3.5.2	 The Magical Effect of Ilizarov Technology on Incurable Diseases
	3.6	 Combvination of Ilizarov Technology and Internal Fixation Technology
		3.6.1	 Ilizarov External Fixator Combined with Plate
		3.6.2	 Ilizarov External Fixator with Intramedullary Nail
	3.7	 Ilizarov Techniques and Chinese Wisdom
		3.7.1	 Wisdom of Ilizarov Devices: Central Fixation
		3.7.2	 Wisdom in Ilizarov Techniques: Firmness and Flexibility
		3.7.3	 Wisdom Among Ilizarov Philosophy: Mystery Code
4: Application of Chinese Hybrid External Fixator
	4.1	 Legendary History of External Fixation in China
	4.2	 Hybrid External Fixator
	4.3	 Application of Hybrid External Fixator in Ankle Orthopedics
		4.3.1	 Indications
		4.3.2	 Basic Principle of Foot and Ankle Fixation for Hybrid External Fixator
		4.3.3	 The Common Configuration of Hybrid External Fixator for Foot and Ankle
	4.4	 Application of Hybrid External Fixator in the Correction of Lower Extremity Deformity
		4.4.1	 Fixation for Acute Correction of Femur Deformity
		4.4.2	 Case Illustration
	4.5	 Application of Hybrid External Fixator After Soft Tissue Surgery and Tendon Transfer for Dynamic Reconstruction
		4.5.1	 Hybrid External Fixation After Achilles Tendon Release for Cerebral Palsy
		4.5.2	 The Acute Correction of the Tendon Displacement in Neuromuscular Disease
	4.6	 The Strategy of Hybrid External Fixation with Internal Fixation
	4.7	 The Structure and Application of Double Barrel Drill Sleeves
		4.7.1	 Origin of Double Barrel Drill Sleeves
		4.7.2	 The Application of Minimally Invasive Osteotomy Device
		4.7.3	 Tips and Tricks
		4.7.4	 The Clinical Practice of Double Barrel Drill Sleeves (Fig. 4.19)
	4.8	 United Application of Chinese Hybrid External Fixator and Ilizarov External Fixator
5: Lower Limb Deformities in Poliomyelitis Sequelae
	5.1	 Introduction
		5.1.1	 The Epidemic History of Poliomyelitis
		5.1.2	 Occurrence and Development Factors of Lower Extremity Deformity in Patients with Poliomyelitis Sequelae
		5.1.3	 Physical Examination
			5.1.3.1	 Gait Analysis
		5.1.4	 Diagnosis
	5.2	 Data Analysis of 23,310 Cases of Polio Sequela
	5.3	 Deformity Classification and Surgical Principles
		5.3.1	 Deformity Classification (Based on the Range of Paralysis)
		5.3.2	 Deformity Classification (Based on the Characteristic and Degree of Deformity)
		5.3.3	 Classification of Muscle Paralysis
		5.3.4	 Classification of Pathological Gait
		5.3.5	 Surgical Indication
		5.3.6	 Principal of Operation
	5.4	 Pelvic Tilt
		5.4.1	 Overview
		5.4.2	 Indications and Strategies of Pelvic Tilt
		5.4.3	 Pelvic Tilt Resulting from Paralytic Scoliosis
			5.4.3.1	 Pathogenesis and Clinical Manifestations
		5.4.4	 Qinsihe Classification of Pelvic Tilt
			5.4.4.1	 Type 1: Pelvic Tilt to Affected Limb
			5.4.4.2	 Type 2: Pelvic Tilt to Healthy Limb
		5.4.5	 Surgical Strategy of Pelvic Tilt
		5.4.6	 Pelvic Tilt of Sub Pelvic Type
			5.4.6.1	 Examination of Pelvic Tilt in Sub Pelvic Type
			5.4.6.2	 Material of Surgical Treatment
		5.4.7	 Measurement of Pelvic Tilt
	5.5	 Paralytic Dislocation of the Hip
		5.5.1	 Overview
		5.5.2	 Favorable Conditions of Surgical Correction for PDH
		5.5.3	 Grading of Paralytic Dislocation of the Hip
		5.5.4	 Surgical Strategies and Methods of PDH
			5.5.4.1	 Adolescent Patients
			5.5.4.2	 The Patient with Grade I PDH with Gluteus Medial Muscle Paralysis and Without Obvious Hip Relaxation
			5.5.4.3	 Modified Tonnis Osteotomy
			5.5.4.4	 The PDH with Femoral Proximal Deformity
			5.5.4.5	 Hybrid Procedure for PDH in Adult
		5.5.5	 Decompensated Contralateral Hip Dislocation
			5.5.5.1	 Pathogenesis
			5.5.5.2	 X-Ray Examination
			5.5.5.3	 Surgical Principle
	5.6	 Flexion Contracture of the Hip
		5.6.1	 Overview
		5.6.2	 Surgical Strategy
			5.6.2.1	 Mild Flexion Deformity of the Hip
			5.6.2.2	 Moderate Hip Flexion Deformity
			5.6.2.3	 Severe Hip Flexion Deformity
			5.6.2.4	 Soft Tissue Release for Flexion Contracture
			5.6.2.5	 Severs Flexion Deformity of the Hip in Adult
			5.6.2.6	 Hip Flexion Combined with Proximal Femur Deformity
			5.6.2.7	 Flexion Contracture of the Hip with Unbearing Leg
			5.6.2.8	 Bilateral Flexion Contracture of the Hip
			5.6.2.9	 Abduction and External Rotation Contracture of Hip
	5.7	 Deformity Correction of the Knee
		5.7.1	 Flexion Deformity of the Knee
			5.7.1.1	 Mechanism of Knee Flexion Deformity
			5.7.1.2	 Clinical Manifestation and Surgical Principles
			5.7.1.3	 Surgical Strategy for Flexion Deformity of the Knee
			5.7.1.4	 Surgical Risks and Complications
			5.7.1.5	 Muscle Transfer for Quadriceps Femoris
			5.7.1.6	 Supracondylar Femur Osteotomy (Fig. 5.45)
				Indication
				Anesthesia and Posture
				Surgical Procedures
				Postoperative Management
				Matters Needing Attention
		5.7.2	 Genu Recurvatum
			5.7.2.1	 Etiology of the Genu Recurvatum
			5.7.2.2	 Classification and Strategy of Surgery for the Genu Recurvatum
				Soft Tissues Type of Genu Recurvatum
				Bone Type of Genu Recurvatum
				Mixed Type of Genu Recurvatum
			5.7.2.3	 Osteotomy Surgery of Genu Recurvatum
			5.7.2.4	 Soft Tissue Natural Reconstruction Using External Fixation
		5.7.3	 External Oblique Abdominal Muscle, Rectus Abdominis Muscle, and Iliotibial Band Transfer for Quadriceps Femoris
			5.7.3.1	 Surgical Indication
			5.7.3.2	 Surgical Procedure
				Surgical Position
				Incision and Procedures
			5.7.3.3	 Postoperative Management
			5.7.3.4	 Summary
	5.8	 Correction Strategy for Foot and Ankle Deformity
		5.8.1	 Types of Foot and Ankle Deformity
		5.8.2	 Deformity Examination and Related Problems of Foot and Ankle
		5.8.3	 Influence of Hip and Knee Deformity on Foot and Ankle
		5.8.4	 Surgical Strategy
		5.8.5	 Decision-Making for Talipes Equinovarus
		5.8.6	 Surgical Treatment for Talipes Equines Retroflexion
			5.8.6.1	 Gait Analysis Preoperatively
			5.8.6.2	 X-Ray Examination
			5.8.6.3	 Pathological Changes
		5.8.7	 Surgical Treatment
	5.9	 Surgical Treatment for Creep-Squatting Cases
		5.9.1	 Data Statistics of Creep-Squatting Cases of Poliomyelitis Sequelae (Tables 5.8, 5.9, 5.10, 5.11, and 5.12)
		5.9.2	 Clinical Manifestation
		5.9.3	 Surgical Indication
			5.9.3.1	 Reflection on the Indications of Surgery
		5.9.4	 Establishment of Surgical Plan
			5.9.4.1	 Follow the Basic Principles of Lower Limb Lengthening and Functional Reconstruction
			5.9.4.2	 Macro Thinking and Systematic Assessment
			5.9.4.3	 Doctors Should Evaluate Themselves
			5.9.4.4	 Optimized Combination of Different Methods
			5.9.4.5	 Postoperative Management
	5.10	 Surgical Treatment for  Post-poliomyelitis Sequelae
		5.10.1	 Data Statistics of 629 Patients of PPS in Qinsihe Orthopedics Institute
		5.10.2	 Surgical Treatment for Aged Patients with PPS
		5.10.3	 Indication
		5.10.4	 The Matters Needing Attention
		5.10.5	 The Matters in Muscle Transfer Surgery for Aged PPS Patients
6: Lower Limb Deformities in Cerebral Palsy
	6.1	 Introduction
	6.2	 Statistical Analysis of 4561 Cases of Cerebral Palsy
	6.3	 Clinical Manifestations and Classifications
		6.3.1	 Physiological Classification and Clinical Manifestations
			6.3.1.1	 Spastic Cerebral Palsy (SCP) (Fig. 6.2)
			6.3.1.2	 Athetoid Dyskinetic Cerebral Palsy (ADCP) (Fig. 6.3)
			6.3.1.3	 Ataxia Cerebral Palsy
			6.3.1.4	 Flaccid Cerebral Palsy (Fig. 6.4)
			6.3.1.5	 Rigid Type (Fig. 6.5)
			6.3.1.6	 Tremor Type
			6.3.1.7	 Mixed Type
		6.3.2	 Classification
	6.4	 Principles of Surgical Treatment and Rehabilitation in Children
		6.4.1	 Aim of Surgical Treatment
		6.4.2	 Surgical Strategies
		6.4.3	 Surgical Treatment of Scissors Gait
			6.4.3.1	 Analysis of the Common Causes
			6.4.3.2	 Indication for Surgery
			6.4.3.3	 Strategy of Surgical Treatment
			6.4.3.4	 Surgical Procedure
		6.4.4	 Typical Case (Fig. 6.7)
		6.4.5	 Contraindication of Surgical Treatment
		6.4.6	 Rehabilitation Principle
	6.5	 Principles and Procedures for Surgical Treatment in Adult
		6.5.1	 Clinical Treatment Strategy
		6.5.2	 Principles of Surgical Treatment
	6.6	 Application of Qin’s Plaster Technique
		6.6.1	 Indication for Gypsum Application
		6.6.2	 Qin’s Method of Plaster Fixation of Lower Limb and Doctor’s Advice on Gypsum
			6.6.2.1	 Indication
			6.6.2.2	 Doctor’s Advice on Gypsum
			6.6.2.3	 Typical Cases
			6.6.2.4	 Combination Method
	6.7	 Application of External Fixation in Severe Knee Flexion Deformity
		6.7.1	 Common Causes
			6.7.1.1	 Dynamic Imbalance
			6.7.1.2	 Static Imbalance
			6.7.1.3	 Lever Arm Dysfunction
			6.7.1.4	 Iatrogenic Factor
		6.7.2	 Ilizarov Technique for the Correction of Severe Lower Limb Deformity in Cerebral Palsy
			6.7.2.1	 Ilizarov Technique for the Correction of Severe Flexion Contractures of the Knee in Cerebral Palsy
		6.7.3	 Correction of Patella Alta in Cerebral Palsy
	6.8	 Functional Exercise
7: Complex Deformity Correction and Functional Reconstruction of Lower Limbs
	7.1	 Definition and Classification of Limb Dysfunction
	7.2	 Surgical Indications and Related Issues
	7.3	 Surgical Strategy for Multiple Joint Deformities
		7.3.1	 Try Best to Correct Multiple Deformity of One Side of Lower Limb at First Stage Surgery
		7.3.2	 Lower Limb Paralysis and Deformity
		7.3.3	 Three Principles of Qin Sihe for Deformity Correction and Functional Reconstruction of Lower Limb Deformity
		7.3.4	 Postoperative Management
		7.3.5	 Case Illustration
	7.4	 Correction of Lower Limb Deformity with Imbalanced Muscle Strength
		7.4.1	 Overview
		7.4.2	 Hip Deformity Combined with Muscle Strength Imbalance
		7.4.3	 Knee Deformity Combined with Imbalanced Muscle Strength
		7.4.4	 Ankle Deformity Combined with Muscle Strength Imbalance
		7.4.5	 Foot Eversion Function Reconstruction
			7.4.5.1	 Lateral Transposition of the Anterior Tibial Muscle
			7.4.5.2	 Replacement of Peroneus Brevis with Posterior Tibial Muscle
		7.4.6	 Reconstruction of the Foot Inversion Dorsal Flexion Function
			7.4.6.1	 Replacement of Anterior Tibial Muscle by Peroneus Longus
			7.4.6.2	 Replacement of Anterior Tibial Muscle with Extensor Hallucis Longus
	7.5	 Correction and Functional Reconstruction of Complex Ankle Deformity
		7.5.1	 Qin’s Basic Strategy for the Correction of Ankle Deformity
			7.5.1.1	 Specific Procedures
		7.5.2	 Application of Ilizarov Technology
		7.5.3	 Postoperative Management
		7.5.4	 Application of  Orthotic Braces
		7.5.5	 Typical Case
	7.6	 Treatment of Severe Limb Deformity Suggested Amputation
		7.6.1	 Introduction
		7.6.2	 Clinical Manifestations and X-Ray Features
		7.6.3	 Preoperative Evaluation
		7.6.4	 Surgical Treatment Principles and Methods
			7.6.4.1	 Principles of Surgical Treatment
			7.6.4.2	 Surgical Methods
			7.6.4.3	 Ankle Deformity with Ulcers
			7.6.4.4	 External Fixation Installation Precautions
			7.6.4.5	 Postoperative Management
		7.6.5	 Prevention and Treatment of Complications
		7.6.6	 Fixator Removal
		7.6.7	 Typical Cases
8: Clinical Data of Congenital Fibular Hemimelia and Tibia Hemimelia
	8.1	 Introduction
		8.1.1	 Why Do Humans Suffer from So Many Congenital Limb Deformities?
		8.1.2	 Deformity Category and Clinical Manifestations
		8.1.3	 The Principle for Congenital Lower Limb Deformity Correction
		8.1.4	 The Experience and Wisdom of Qin Orthopedics in Lower Limb Deformity Correction
	8.2	 Congenital Deformity of Hip and Knee Joint
		8.2.1	 Congenital Dislocation of the Hip
			8.2.1.1	 Clinical Data of DDH in Qinsihe Orthopedics Institute
			8.2.1.2	 Ilizarov Pelvic Support Osteotomy
				Introduction
				Operative Principle
				Preoperative Examination and Design
				Experiences in Surgical Management
				Typical Cases
		8.2.2	 Congenital Dislocation of the Patella
			8.2.2.1	 Clinical Data of Congenital Patellar Dislocation in Qinsihe Orthopedic Institute
			8.2.2.2	 Clinical Manifestation
			8.2.2.3	 Treatment
			8.2.2.4	 Typical Cases
	8.3	 Congenital Foot Deformity
		8.3.1	 Clubfoot (Talipes Equinovarus)
			8.3.1.1	 Clinical Data of 701 Cases with Clubfoot in Qinsihe Orthopedics Institute
			8.3.1.2	 Clinical Manifestations
			8.3.1.3	 Conservative Indications and Options
				Flexible Clubfoot
				Rigid Clubfoot
			8.3.1.4	 Surgical Principle for Clubfoot in Qinsihe Orthopedics Institute
				Clubfoot with Mild Joint Stiffness
				Club Foot with Severe Joint Stiffness
			8.3.1.5	 Qin’s Correction Principle for Clubfoot in Children (<10 Years Old)
			8.3.1.6	 Qin’s Correction Principle for Clubfoot in Adult
			8.3.1.7	 Typical Cases
		8.3.2	 Congenital Vertical Talus
			8.3.2.1	 Clinical Data of 11 Cases with CVT in Qinsihe Orthopedics Institute
			8.3.2.2	 Etiology and Pathology
			8.3.2.3	 Clinical Manifestation
				Clinical Presentation
				Key Points of Radiology and Examination
			8.3.2.4	 Surgical Principle for CVT Patient
			8.3.2.5	 Surgical Methods
			8.3.2.6	 Postoperative Management
			8.3.2.7	 Typical Cases
		8.3.3	 Congenital Brachymetatarsia
			8.3.3.1	 Clinical Data of 10 Cases with Branchymetatarsia in Qinsihe Orthopedics Institute
			8.3.3.2	 Clinical Manifestation
			8.3.3.3	 Strategies, Methods, and Procedures
				Metatarsal Lengthening Using Unilateral Fixator
				Metatarsal Lengthening Using Ilizarov Lengthening Method
			8.3.3.4	 Tips and Tricks
			8.3.3.5	 Postoperative Management
			8.3.3.6	 Complications
				Pin Tract Infection
				Over- or Under-lengthening
				Metatarsophalangeal Stiffness
				Metatarsophalangeal Subluxation
			8.3.3.7	 Typical Cases
	8.4	 Congenital Pseudarthrosis of the Tibia
		8.4.1	 Clinical Data
		8.4.2	 Clinical Manifestations
		8.4.3	 The Principles of Surgical Treatment
		8.4.4	 Surgical Procedures
		8.4.5	 Application of Ilizarov External Fixator
		8.4.6	 Postoperative Management
		8.4.7	 Typical Cases
	8.5	 Congenital Fibular Hemimelia and Tibia Hemimelia
		8.5.1	 Congenital Fibular Hemimelia
			8.5.1.1	 Clinical Data of Congenital Fibular Hemimelia and Tibia Hemimelia
			8.5.1.2	 Etiology
			8.5.1.3	 Clinical Manifestation
			8.5.1.4	 The Goal of Treatment
			8.5.1.5	 Operation Procedures
			8.5.1.6	 Tips and Tricks
			8.5.1.7	 Postoperative Management
			8.5.1.8	 Complication
			8.5.1.9	 Typical Cases
		8.5.2	 Congenital Tibia Hemimelia
			8.5.2.1	 Etiology and Pathogenesis
			8.5.2.2	 Clinical Manifestation
			8.5.2.3	 Typical Cases
	8.6	 Congenital Macrodactylism
		8.6.1	 Clinical Data of Congenital Macrodactylism (Table 8.14)
		8.6.2	 Etiology and Pathogenesis
		8.6.3	 Clinical Manifestations
		8.6.4	 X-Ray and Imaging Examination
		8.6.5	 Surgical Strategy
		8.6.6	 Surgical Procedures
			8.6.6.1	 Toes Shortening Procedure
				Surgical Methods
			8.6.6.2	 The Procedure for Toe and Metatarsus Removal
				Surgical Method
				Factors to Ensure Successful Surgery
				Postoperative Management
		8.6.7	 Typical Case
	8.7	 Congenital Constricting Band Syndrome
		8.7.1	 Clinical Data (Table 8.15)
		8.7.2	 Clinical Manifestations
		8.7.3	 Goals and Ideas of Treatment
			8.7.3.1	 Surgical Procedures
		8.7.4	 Tips and Tricks
		8.7.5	 Typical Case
		8.7.6	 The Band Release with Transverse Incision
			8.7.6.1	 Typical Case
9: Lower Limb Deformity Caused by Hereditary and Metabolic Diseases
	9.1	 Lower Limb Deformity Caused by Hereditary Sensorimotor Neuropathy (Charcot–Marie–Tooth)
		9.1.1	 Clinical Data of Limb Deformity
		9.1.2	 Clinical Characters of Foot and Ankle Deformity
		9.1.3	 X-Ray Features of Ankle and Foot
		9.1.4	 Principles and Procedures of Surgical Treatment
		9.1.5	 Expected Therapeutic Objectives and Advantages of External Fixators
		9.1.6	 Surgical Procedure and Risk Avoidance
		9.1.7	 Postoperative Management
		9.1.8	 Functional Exercise
		9.1.9	 Complications
		9.1.10	 Fixator Removal
		9.1.11	 Typical Cases
	9.2	 Lower Limb Deformity Caused by Osteogenesis Imperfecta
		9.2.1	 Clinical Data of Lower Limb Deformity
		9.2.2	 Pathological Characteristics of OI in Adult
		9.2.3	 Clinical Manifestation
		9.2.4	 X-Ray Characters
		9.2.5	 Diagnosis and Treatment
		9.2.6	 Application of Ilizarov Technique in OI Deformity
		9.2.7	 Typical Case
	9.3	 Severe Osteoporosis with Limb Deformities
		9.3.1	 A Thin Reconstruction Plate for Internal Fixation of Femoral Shaft Osteotomy
		9.3.2	 Correction of Tibial Deformity
		9.3.3	 Severe Foot and Ankle Deformity with Severe Osteoporosis
		9.3.4	 Clinical Case (Fig. 9.28)
	9.4	 Lower Limb Deformity Caused by Rickets
		9.4.1	 Etiology and Pathogenesis
			9.4.1.1	 Introduction
			9.4.1.2	 Etiology
			9.4.1.3	 Pathogenesis
		9.4.2	 Clinical Manifestations and Examination Points
		9.4.3	 Clinical Data of Lower Limb Deformity Caused by Rickets
		9.4.4	 Treatment Protocols
		9.4.5	 Tips and Tricks
			9.4.5.1	 Correction of Thigh Deformity
			9.4.5.2	 Correction of the Calf Deformity
			9.4.5.3	 Drug Therapy
			9.4.5.4	 Design of External Fixator
		9.4.6	 Postoperative Management
		9.4.7	 Complications
		9.4.8	 Typical Cases
	9.5	 Achondroplasia
		9.5.1	 Clinical Data of Achondroplasia in Qin Sihe Orthopedics Institute
		9.5.2	 Etiology
		9.5.3	 Clinical Manifestation
		9.5.4	 Goal and Idea of Treatment
		9.5.5	 Typical Case
	9.6	 Lower Limb Deformity Caused by Melorheostosis
		9.6.1	 Data Analysis
		9.6.2	 Etiology and Pathogenesis
		9.6.3	 Clinical Manifestations
		9.6.4	 X-Ray
		9.6.5	 Pathological Diagnosis
		9.6.6	 Treatment Goal
		9.6.7	 Typical Case
	9.7	 Lower Limb Deformity Caused by Hemophilia
		9.7.1	 Clinical Manifestation
		9.7.2	 Treatment
		9.7.3	 Typical Case
10: Traumatic Sequelae of Lower Limb
	10.1	 Clinical Data
	10.2	 Clinical Manifestations
		10.2.1	 Pelvic Fracture Malunion
		10.2.2	 Thigh Traumatic Sequelae
			10.2.2.1	 Open Femoral Fracture with Bone Defect
			10.2.2.2	 Nonunion of Femoral Fracture
			10.2.2.3	 Malunion of Femoral Fracture
		10.2.3	 Traumatic Sequelae of Knee
			10.2.3.1	 Genu Valgum
			10.2.3.2	 Genu Varum
			10.2.3.3	 Knee Dislocation
			10.2.3.4	 Knee Stiffness
			10.2.3.5	 Knee Flexion Deformity
			10.2.3.6	 Knee Recurvation Deformity
		10.2.4	 The Traumatic Sequelae of Calf
			10.2.4.1	 Bone Defect After Open Tibial Fracture
			10.2.4.2	 Tibial Malunion
			10.2.4.3	 Nonunion of Tibial Fracture
		10.2.5	 The Traumatic Sequelae of Foot and Ankle
			10.2.5.1	 Ankle Varus Deformity
			10.2.5.2	 Ankle Valgus Deformity
			10.2.5.3	 Rigid Clubfoot
			10.2.5.4	 Ankle Valgus Deformity
			10.2.5.5	 Other Ankle Deformities
		10.2.6	 Multiple Deformities
	10.3	 Preoperative Assessment and Correction Strategies of Deformities
		10.3.1	 Preoperative Assessment
		10.3.2	 Deformity Correction Strategy
	10.4	 Correction Methods for Different Deformities
		10.4.1	 Introduction
		10.4.2	 Correction Methods for Different Deformities
			10.4.2.1	 Malunion After Traumatic Fracture
			10.4.2.2	 Bone and Joint Deformities Caused by Scar Contracture
			10.4.2.3	 Bone and Joint Deformities Caused by Ischemic Muscle Contracture After Vascular Injury
			10.4.2.4	 Bone and Joint Deformities Caused by Muscle Imbalance After Incomplete Central or Peripheral Nerve Injury
			10.4.2.5	 Joint Deformity Caused by Early Closure of the Epiphysis Resulting from Trauma or Infection (Fig. 10.30)
			10.4.2.6	 Joint Deformity Caused by Septic Arthritis in Infants
			10.4.2.7	 Complex Lower Limb Deformities Caused by Severe Complex Injury
	10.5	 Lower Limb Deformities Caused by Bone and Joint Tuberculosis
		10.5.1	 Typical Cases
	10.6	 Lower Limb Deformity Caused by Septic Arthritis
		10.6.1	 Septic Sequelae of the Hip
			10.6.1.1	 The Hip Joint Is Fused at the Deformed Position of Flexion and Abduction (Fig. 10.34)
			10.6.1.2	 The Right Hip Stiffness with Femoral Head Collapsed (Fig. 10.35)
			10.6.1.3	 Hip Dislocation and Stiffness at Adduction Position (Fig. 10.36)
		10.6.2	 Septic Sequelae of the Knee
			10.6.2.1	 Severe Knee Flexion Deformity (Fig. 10.37)
			10.6.2.2	 Severe Compound Deformity of the Knee (Fig. 10.38)
		10.6.3	 Septic Sequelae of the Knee (Fig. 10.39)
	10.7	 Lower Extremity Deformities with Extensive Skin Scar Contracture
		10.7.1	 Hip Deformity Caused by Scar Contracture (Fig. 10.40)
		10.7.2	 Knee Deformity Caused by Thigh Scar Contracture (Fig. 10.41)
		10.7.3	 Ankle and Foot Deformity Caused by Calf Scar Contracture (Fig. 10.42)
	10.8	 Foot and Ankle Deformity Caused by Ischemic Muscle Contracture
		10.8.1	 Introduction
		10.8.2	 Type of Foot and Ankle Deformities and Clinical Manifestations
		10.8.3	 Surgical Treatment Principles and Classic Surgical Methods
		10.8.4	 The Advantages and Principle of Ilizarov Technology
		10.8.5	 The Step for External Fixator Application and Avoiding Surgical Risk
		10.8.6	 Postoperative Management and Prevention of Complications
		10.8.7	 Typical Cases
	10.9	 Developmental Deformities of Lower Extremity Caused by Physeal Injury
		10.9.1	 The Mechanism of Lower Limb Deformity After Physeal Injury
		10.9.2	 Clinical Examination and Imaging of Limb Deformity Caused by Physeal Injury
		10.9.3	 Surgical Treatment of Physeal Injury, Limb Shortening, and Deformity
		10.9.4	 Typical Cases
11: Lower Limb Deformity Caused by Spina Bifida Sequelae and Tethered Cord Syndrome
	11.1	 Introduction
	11.2	 The Relationship Between Spinal Lamina Defect and Clinical Manifestations
	11.3	 Characteristics of Lower Limb Deformities of Spinal Bifida Sequela
	11.4	 Clinical Manifestations and Classifications
	11.5	 Physical Examination and Radiological Examination
		11.5.1	 Physical Examination
			11.5.1.1	 Lower Limb Examination
			11.5.1.2	 Waist Examination
		11.5.2	 Radiology Examination
		11.5.3	 Checklist for the Lower Limb Deformity of Spina Bifida Sequelae
	11.6	 Principles of Deformity Correction and Functional Reconstruction
		11.6.1	 Overview
		11.6.2	 Surgical Indication
		11.6.3	 Basic Principles of Surgery
		11.6.4	 Qinsihe Orthopedic Experiences and Precautions
		11.6.5	 How to Optimize the Combination of Different Surgical Methods?
		11.6.6	 The Rational Application of External Fixation (Ilizarov) Technology
	11.7	 Correction of Foot and Ankle Deformity with Ulceration
	11.8	 Clinical Data of Lower Limb Deformities of Spina Bifida Sequelae
		11.8.1	 Clinical Data
		11.8.2	 Atlas of Typical Cases
	11.9	 Conclusion
12: Lower Limb Deformities Caused by Immunological Diseases and Viral Infectious Diseases
	12.1	 Introduction
		12.1.1	 Relationship Between Immunological Diseases and Viral Infectious Diseases
		12.1.2	 Diagnosis and Treatment
		12.1.3	 Characteristics of Surgical Treatment
	12.2	 Lower Limb Deformity Caused by Rheumatoid Disease
		12.2.1	 Etiopathogenesis and Pathogenesis
		12.2.2	 Clinical Manifestation and Key Points of Examination
		12.2.3	 Typical Cases
		12.2.4	 The Data of Lower Limb Deformity Caused by Rheumatoid Arthritis (Table 12.1)
	12.3	 Lower Limb Deformity Caused by Scleroderma
		12.3.1	 Etiopathogenesis and Pathogenesis
		12.3.2	 Clinical Manifestations and Key Points of Examination
		12.3.3	 Principles of Surgical Treatment
		12.3.4	 Typical Cases
		12.3.5	 The Surgical Data of Limb Deformity Caused by Scleroderma (Table 12.2)
		12.3.6	 Conclusion
	12.4	 Lower Limb Deformity Caused by Dermatomyositis
		12.4.1	 Etiopathogenesis and Pathogenesis
		12.4.2	 Clinical Manifestations and Key Points of Examination
		12.4.3	 Typical Case
	12.5	 Lower Limb Deformity Caused by GBS
		12.5.1	 Etiopathogenesis and Pathogenesis
		12.5.2	 Clinical Manifestations and Key Points of Examination
		12.5.3	 Typical Cases
		12.5.4	 The Clinical Data of Lower Limb Deformity Caused by GBS (Table 12.3)
	12.6	 Lower Limb Deformity Caused by Hand-Foot and Mouth Disease
		12.6.1	 Etiopathogenesis and Pathogenesis
		12.6.2	 Clinical Manifestations and Key Points of Examination
		12.6.3	 Typical Cases
		12.6.4	 Clinical Data of Limb Deformities Caused by HFMD in Qinsihe Orthopedics (Table 12.4)
13: Nonunion, Bone Defects and Osteomyelitis
	13.1	 Clinical Data
	13.2	 Breaks Through the restrict Bottleneck treatment of Nonunion and Bone Defect
		13.2.1	 Nonunion, Bone Defect, and “Fracture Disease”
		13.2.2	 Bone Metabolism Is Regulated by Stress
		13.2.3	 Distraction Osteogenesis (DO) Is Gold Standard for the Treatment of Nonunion and Bone Defects
		13.2.4	 Summary
	13.3	 Femoral Nonunion, Bone Defect, and Osteomyelitis
		13.3.1	 Etiology, Pathogenesis, and Classification
			13.3.1.1 Etiology and Pathogenesis
			13.3.1.2 Clinical Manifestations and Imaging
			13.3.1.3 Surgical Treatment Goals
			13.3.1.4 Surgical Procedures, External Fixation Configuration, Operating Procedures, and Surgical Risk Avoidance
			13.3.1.5 Postoperative Management
			13.3.1.6 Removal of External Fixation
			13.3.1.7 Typical Cases
			13.3.1.8 Summary
	13.4	 Tibial Nonunion and Defect
		13.4.1	 Tibial Nonunion
			13.4.1.1 Indications
			13.4.1.2 Preoperative Evaluation
			13.4.1.3 Preoperative Preparation
			13.4.1.4 Surgical Procedure
			13.4.1.5 Postoperative Management
			13.4.1.6 Typical Cases
		13.4.2	 Tibial Bone Defect
			13.4.2.1 Surgical Indications
			13.4.2.2 Preoperative Examination and Preoperative Preparation
			13.4.2.3 Surgical Plan
			13.4.2.4 Surgical Procedure
			13.4.2.5 Typical Cases
	13.5	 Fibular Bone Defect
		13.5.1	 Overview
		13.5.2	 The Reconstruction of Distal Fibular Defect
		13.5.3	 Typical Case
	13.6	 Bone Nonunion and Defect on Foot
		13.6.1	 Calcaneal Defect
			13.6.1.1 Etiology
			13.6.1.2 Clinical Manifestation and Key Points of Examination
			13.6.1.3 Indications and Contraindications for Calcaneus Reconstruction with Distraction Osteogenesis
			13.6.1.4 Treatment Goals and Ideas
			13.6.1.5 Surgical Procedures
			13.6.1.6 Tips and Tricks
			13.6.1.7 Postoperative Management
			13.6.1.8 Possible Complications
			13.6.1.9 Typical Cases
		13.6.2	 Metatarsal Defect and Nonunion
			13.6.2.1 Etiology
			13.6.2.2 Clinical Manifestation and Key Points of Examination
			13.6.2.3 Indications and Contraindications
			13.6.2.4 The Goal and Idea of Treatment
			13.6.2.5 Typical Case
	13.7	 Treatment of Tibial Defects Combined with Talipes Deformity
		13.7.1	 The Configuration of External Fixator
		13.7.2	 Surgical Plan
		13.7.3	 Postoperative Management
		13.7.4	 Typical Cases
	13.8	 Prevention and Treatment of the Secondary Problems
		13.8.1	 Pin Tract Infection
		13.8.2	 Axial Deviation of Moving Bone Segment (Fig. 13.35)
		13.8.3	 Skin Depression
	13.9	 Chronic Osteomyelitis of Lower Limbs
		13.9.1	 Introduction
			13.9.1.1 Shortening and Lengthening After Bone Segments Resection (Fig. 13.38)
			13.9.1.2 Bone Transport for Restoration of Bone Defects (Fig. 13.39)
			13.9.1.3 The Choice of External Fixator
			13.9.1.4 The Method for Pin Inserting
			13.9.1.5 The Location for Osteotomy
			13.9.1.6 The Time for Osteotomy
			13.9.1.7 Lengthening Method
			13.9.1.8 Bone Formation
			13.9.1.9 Treatment of Atrophic Osteogenesis
			13.9.1.10 Fixator Removal
		13.9.2	 Femoral Osteomyelitis
			13.9.2.1 Indications
			13.9.2.2 Preoperative Examination
			13.9.2.3 Apparatus Configuration
			13.9.2.4 Surgical Steps
			13.9.2.5 Wire Distribution
			13.9.2.6 Important Matters
			13.9.2.7 Postoperative Management
			13.9.2.8 Typical Case
		13.9.3	 Tibial Osteomyelitis
			13.9.3.1 The Configuration of External Fixation
			13.9.3.2 Surgical Steps
			13.9.3.3 Matters Need Attention
			13.9.3.4 Postoperative Management
			13.9.3.5 Typical Cases
		13.9.4	 Tibia Osteomyelitis in Children
14: Genu Varum, Genu Valgum, and Osteoarthritis of Knee
	14.1	 Statistical Analysis of 753 Cases of Genu Varum, Genu Valgum, and Osteoarthritis of Knee
	14.2	 Clinical Manifestations and Preoperative Examination
		14.2.1	 Clinical Manifestations and Classifications
			14.2.1.1	 Genu Varum
			14.2.1.2	 Genu Valgum
		14.2.2	 Preoperative Checklists
			14.2.2.1	 Physical Examinations
			14.2.2.2	 X-Ray
	14.3	 Qin’s Classification and Surgical Indications
		14.3.1	 Qinsihe’s Classification for Genu Varum and Genu Valgum
			14.3.1.1	 Genu Varum
			14.3.1.2	 Genu Valgum
		14.3.2	 Surgical Indications
	14.4	 Mild Genu Varum
		14.4.1	 Diagnostic Criteria
		14.4.2	 Classifications
		14.4.3	 Treatment
			14.4.3.1	 Femoral Type: Valgus Osteotomy on the Femoral Condyle
			14.4.3.2	 Tibia Type: Valgus Osteotomy Below Tibial Tuberosity
			14.4.3.3	 Mixed Type
	14.5	 Severe Genu Varum
		14.5.1	 Diagnostic Criteria
		14.5.2	 Etiology and Clinical Manifestations
		14.5.3	 Auxiliary Examination
		14.5.4	 Treatment Strategy
		14.5.5	 Typical Cases
	14.6	 Genu Valgum
		14.6.1	 Definition
		14.6.2	 Analysis of Common Cause
		14.6.3	 Surgical Indications
		14.6.4	 Analysis of Genu Valgum
		14.6.5	 Goals and Ideas of Treatment
		14.6.6	 Typical Cases
	14.7	 Windswept Deformity in Lower Limb
		14.7.1	 Definition
		14.7.2	 Characteristics of Deformities
		14.7.3	 Treatment
		14.7.4	 Typical Case
	14.8	 Knee Osteoarthritis with Tibia Varus Deformity
	14.9	 Tibia Vara
		14.9.1	 Etiology
		14.9.2	 Pathology
		14.9.3	 Symptoms and Signs
		14.9.4	 X-Ray Findings
		14.9.5	 Treatment
		14.9.6	 Typical Case
15: Lower Limb Deformities Caused by Hemangiomas and Vascular Disorders
	15.1	 Introduction
		15.1.1	 Lower Limb Deformities Caused by Hemangioma
		15.1.2	 Ilizarov Reconstruction of Ischemic Disorders
	15.2	 Clinical Data of Hemangioma with Lower Extremity Deformity (Tables 15.1, 15.2, 15.3, and 15.4)
	15.3	 Lower Limb Deformity Caused by Hemangioma
		15.3.1	 Common Reasons for Lower Limb Deformity Caused by Hemangioma
		15.3.2	 Clinical Manifestations
		15.3.3	 Imaging Characteristics
		15.3.4	 Classification
		15.3.5	 Surgical Principles for Lower Extremity Deformity Caused by Hemangioma
			15.3.5.1	 Basic Principles of Surgical Treatment
			15.3.5.2	 Surgical Method
			15.3.5.3	 How to Avoid Bleeding During and After Surgery?
			15.3.5.4	 Application of a Plaster Cast
			15.3.5.5	 Application of Orthosis
		15.3.6	 Typical Cases (Fig. 15.10)
	15.4	 Lower Limb Ischemic Diseases
		15.4.1	 Overview
		15.4.2	 Treatment of Diabetic Foot Conditions and Pathology
			15.4.2.1	 Introduction
			15.4.2.2	 The Pathogenesis of Diabetic Foot
			15.4.2.3	 Clinical Manifestation and Classification
			15.4.2.4	 Traditional Surgical Treatment
			15.4.2.5	 Surgical Methods and Postoperative Management of Ilizarov Technique
			15.4.2.6	 Typical Cases
			15.4.2.7	 Clinical Data of Diabetic Foot
			15.4.2.8	 Future Trends
		15.4.3	 Treatment of Thromboangiitis Obliterans
			15.4.3.1	 Introduction
			15.4.3.2	 Surgical Methods and Postoperative Management
16: Lower Limb Deformity Caused by Tumor and Tumor-Like Disease
	16.1	 Lower Limb Deformity Caused by Osteofibrous Dysplasia
		16.1.1	 Etiology and Pathogenesis
		16.1.2	 Clinical Manifestation and Key Points of Physical Examination
		16.1.3	 Typical Case (Fig. 16.4)
			16.1.3.1	 General Information
			16.1.3.2	 Treatment Protocols
			16.1.3.3	 Surgical Technique
			16.1.3.4	 Tips and Tricks
			16.1.3.5	 Postoperative Management
	16.2	 Lower Limb Deformity Caused by Spinal Cord Tumor
		16.2.1	 Etiology and Pathogenesis
		16.2.2	 Clinical Manifestation and Key Points of the Physical Examination
			16.2.2.1	 Pain and Sensory Disturbance
			16.2.2.2	 Dyskinesia
			16.2.2.3	 Limb Deformity
		16.2.3	 Typical Case
			16.2.3.1	 General Information
			16.2.3.2	 Treatment Protocols
			16.2.3.3	 Tips and Tricks
			16.2.3.4	 Postoperative Management
	16.3	 Lower Limb Deformity Caused by Lymphangioma
		16.3.1	 Etiology and Pathogenesis
		16.3.2	 Clinical Manifestation
		16.3.3	 Typical Case
			16.3.3.1	 General Information
			16.3.3.2	 Treatment Protocols
			16.3.3.3	 Surgical Technique
			16.3.3.4	 Tips and Tricks
			16.3.3.5	 Postoperative Management
	16.4	 Lower Limb Deformity Caused by Enchondroma
		16.4.1	 Etiology and Pathogenesis
		16.4.2	 Clinical Manifestations and Keys of Physical Examination
		16.4.3	 Typical Case (Fig. 16.8)
			16.4.3.1	 General Information
			16.4.3.2	 Treatment Protocols
			16.4.3.3	 Surgical Technique
			16.4.3.4	 Tips and Tricks
	16.5	 Lower Limb Deformity Caused by Adenomatous Hyperparathyroidism Syndrome (Parathyroid Adenoma)
		16.5.1	 Clinical Symptoms and Physical Examination
		16.5.2	 Treatment
		16.5.3	 Typical Cases (Fig. 16.11)
			16.5.3.1	 General Information
			16.5.3.2	 Treatment Protocols
			16.5.3.3	 Surgical Techniques
	16.6	 Lower Extremity Deformity Caused by Hard Fibroma
		16.6.1	 Etiology
		16.6.2	 Clinical Manifestations and Physical Examinations
		16.6.3	 Treatment Objective
		16.6.4	 Treatment Strategy
		16.6.5	 Typical Cases
17: Lower Limb Deformities Caused by Iatrogenic Factors and Social Reasons
	17.1	 Clinical Data
		17.1.1	 Etiology Analysis
		17.1.2	 Gender Analysis
		17.1.3	 Age Analysis
	17.2	 Gluteal Muscle Contracture
		17.2.1	 Clinical Manifestation
		17.2.2	 Typical Case
	17.3	 Other Iatrogenic Deformities
		17.3.1	 Statistics of 67 Cases of Iatrogenic Deformities
		17.3.2	 Clinical Manifestation
		17.3.3	 Surgical Strategy
		17.3.4	 Typical Cases
	17.4	 Lower Limb Deformity Caused by Ischemic Muscle Contracture
		17.4.1	 Typical Cases
	17.5	 Lower Limb Deformity Caused by Carbon Monoxide Poisoning
		17.5.1	 Typical Case
	17.6	 Lower Limb Deformity Caused by Sugarcane Poisoning
		17.6.1	 Typical Case (Fig. 17.13)
	17.7	 Lower Limb Deformity Caused by Animal Bite
		17.7.1	 Lower Limb Deformity Caused by Snake Bite
			17.7.1.1	 Typical Case (Fig. 17.14)
		17.7.2	 Lower Limb Deformity Caused by Bear Scratch
			17.7.2.1	 Typical Case (Fig. 17.15)
18: Limb Length Discrepancy
	18.1	 Data Analysis of 2549 Cases of Lower Limb Lengthening Surgery
	18.2	 Surgical Indication and Strategy of Leg Length Discrepancy
	18.3	 Ilium Lengthening
		18.3.1 Indication
		18.3.2 Surgical Procedures
		18.3.3 Postoperative Management
		18.3.4 Typical Case
			18.3.4.1	 Surgical Plan
			18.3.4.2	 Preoperative Preparation
			18.3.4.3	 The Surgical Procedures
			18.3.4.4	 Tips and Tricks
			18.3.4.5	 Postoperative Management
	18.4	 Femur Lengthening
		18.4.1 Common Instruments
		18.4.2 Preoperative Preparation
		18.4.3 Surgical Procedures
			18.4.3.1	 Femur Lengthening with Ilizarov External Fixator
				The Osteotomy Plane (Fig. 18.7)
				Predrill (Fig. 18.8)
				Application of Femoral Lengthener (Fig. 18.9)
				Femoral Osteotomy (Fig. 18.10)
			18.4.3.2	 Femur Lengthening with Unilateral External Fixator
				Make Sure the Osteotomy Plane
				Pin Fixation
				Minimally Invasive Osteotomy
		18.4.4 Postoperative Management
		18.4.5 Typical Case
		18.4.6 Femur Immediate Lengthening
			18.4.6.1	 Typical Case
	18.5	 Tibia Lengthening
		18.5.1 Preoperative Design
		18.5.2 Surgical Procedure
			18.5.2.1	 Fibula Osteotomy (Fig. 18.16)
			18.5.2.2	 Tibial Osteotomy (Fig. 18.17)
			18.5.2.3	 Apparatus Installation for Tibial Lengthening (Fig. 18.18)
			18.5.2.4	 Tibial Breaking (Fig. 18.19)
		18.5.3 Postoperative Management
			18.5.3.1	 Postoperative Treatment and Nursing
			18.5.3.2	 Management in Lengthening Period
				Lengthening Index
			18.5.3.3	 Prevention of Foot Deformity
				Prevention of Knee Flexion Deformity
			18.5.3.4	 Management of Delay Period
		18.5.4 Typical Case
	18.6	 Cosmetic Lengthening
		18.6.1 Indication
		18.6.2 Contraindication
		18.6.3 Operative Option
		18.6.4 Preoperative Preparation
		18.6.5 Surgical Procedures
			18.6.5.1	 Tibial Lengthening with External Fixation
			18.6.5.2	 Tibial Lengthening with Fixator over Intramedullary Nail
			18.6.5.3	 Femoral Lengthening with External Fixation
			18.6.5.4	 Femoral Lengthening with External Fixator over Nail
		18.6.6 Postoperative Management
		18.6.7 Typical Case
	18.7	 Lower Limb Lengthening with Fixator and Intramedullary Nail
		18.7.1 Femoral Lengthening Using Ilizarov Fixator over Intramedullary Nail
			18.7.1.1	 Indication
			18.7.1.2	 Configuration of Ilizarov External Fixator for Femoral Lengthening (Fig. 18.23)
			18.7.1.3	 Wire Layout
			18.7.1.4	 Preparation Preoperatively
			18.7.1.5	 Surgical Procedures
			18.7.1.6	 Postoperative Management
		18.7.2 Tibial Lengthening Using Ilizarov Fixator over Intramedullary Nail
			18.7.2.1	 Overview
			18.7.2.2	 Indication
			18.7.2.3	 Surgical Procedure
				Anesthesia
				Posture
				Surgical Procedures
				Surgical Risk Avoidance
			18.7.2.4	 Postoperative Management
			18.7.2.5	 Complications
			18.7.2.6	 Fixator Removal and Application of Assistant Devices
			18.7.2.7	 Typical Case
	18.8	 Application of Elastic Apparatus for Tibia Lengthening
		18.8.1 Background
		18.8.2 Details of Elastic Apparatus for Tibia Lengthening
		18.8.3 Surgical Procedures
		18.8.4 Application of Elasticity Apparatus for Tibia Lengthening
		18.8.5 Typical Case
	18.9	 Foot Lengthening
		18.9.1 Calcaneus Lengthening
			18.9.1.1	 Surgical Indications
			18.9.1.2	 Surgical Procedures
			18.9.1.3	 Postoperative Management
			18.9.1.4	 Rehabilitation
			18.9.1.5	 Typical Case
		18.9.2 Midfoot Lengthening
			18.9.2.1	 Clinical Manifestations
			18.9.2.2	 Principles and Methods of Surgical Treatment
			18.9.2.3	 Installation of Ilizarov Fixator
			18.9.2.4	 Postoperative Management
			18.9.2.5	 Complications
			18.9.2.6	 Fixator Removal
			18.9.2.7	 Typical Case
	18.10	 The Complications of Lower Limb Lengthening
		18.10.1 Introduction
			18.10.1.1	 The Definition of Complication
			18.10.1.2	 Classification of Complications
				Paley Classification
				Xia Classification
		18.10.2 Intraoperative Complications
			18.10.2.1	 Thermal Injury
			18.10.2.2	 Neurovascular Injury
			18.10.2.3	 Broken Drill Bit
		18.10.3 Complications Before Lengthening
			18.10.3.1	 Pin Tract Infection
			18.10.3.2	 Joint Dysfunction
		18.10.4 Complications During the Lengthening Period
			18.10.4.1	 Joint Deformity
			18.10.4.2	 Joint Dislocation
			18.10.4.3	 Wire Breaking
		18.10.5 Complications in Bone Mineralization
		18.10.6 Complications After Fixator Removal
		18.10.7 Other Complications
			18.10.7.1	 Erythra
			18.10.7.2	 Skin Compression