Challenges in Reconstruction and Limb Lengthening Surgery for Congenital Lower Limb Deficiencies.

Background/Objectives: Lower limb congenital deficiencies represent challenging disorders that require a complex strategy for limb reconstruction and lengthening procedures guided by the anatomical type and severity of the deformity. This review aims to summarize current treatment approaches in limb reconstruction and lengthening for patients with common congenital lower limb deficiencies, including fibular hemimelia, congenital femoral deficiency, and tibial hemimelia. Methods: A literature search was conducted using major databases, complemented by the senior author's clinical experience and case series, to identify relevant studies and current procedures for the management of common congenital lower limb deficiencies, including limb reconstruction and lengthening techniques. Results: The various clinical presentation and classification systems of congenital lower limb deficiencies are presented, as well as up to date surgical techniques including limb reconstruction and lengthening. These approaches demonstrated effectiveness in congenital limb deficiencies management by facilitating joint stabilization and subsequent limb lengthening, leading to improved functional outcomes. However, significant challenges persist, including prolonged treatment duration and patient discomfort. Modern surgical approaches have significantly improved the outcomes of treatment for congenital limb deficiencies. However, the complexity of these clinical entities requires individualized treatment strategies. Conclusions: Successful management of congenital lower limb deficiencies relies on individualized, patient-specific treatment planning, incorporating preparatory surgical interventions and sequential limb lengthening procedures to maximize functional outcomes.