The SUPER-Ankle procedure is a complex procedure to reconstruct a functional ankle in cases where the ankle and foot are malformed due to congenital hypoplasia (fibular hemimelia, etc). This is a complex procedure for a rather rare condition, requiring specific knowledge and experience in this field.
SUPERAnkle Intervention
OrthoChildren (Bologna, Italy) is among the international centers with experience in this field.
Dr. Lampasi has been specializing in congenital hypoplasia and joint reconstruction for years. He worked first at the Rizzoli Orthopedic Institute (Bologna, Italy), where many of the first scientific studies on this type of procedure and congenital hypoplasia were conducted (Prof. Dal Monte, Dr. Donzelli). He then served as Head of Pediatric Orthopedics at Meyer Hospital in Florence, where he performed several complex procedures in this field for the first time at that hospital. Finally, he performed numerous cases of joint reconstruction (SUPERAnkle, etc.) at various public and private Italian hospitals, also providing consulting and training to other pediatric orthopedic surgeons.
Dr. Lucchesi has been dedicated to the treatment of congenital hypoplasia for years, has attended numerous courses and conferences held by Professor Dror Paley, who systematized many of the procedures in this field, and has undertaken extended training periods with Dr. Alexander Kirienko, a luminary in external fixation with the Ilizarov apparatus.
SUPERAnkle’s Intervention: What does SUPER mean?
The SUPERAnkle procedure belongs to a series of procedures with the prefix SUPER, an acronym that stands for Systematic Utilitarian Procedure for Extremity Reconstruction, conceived and systematized by Professor Dror Paley.
In congenital hypoplasias (fibular hemimelia, tibial hemimelia, femoral hypoplasia, Congenital Femoral Deficiency CFD), the affected limbs are not only more or less significantly shorter, but also show associated deformities at the level of the main joints: hip, knee, ankle, foot.
In the past, these deformities were given less importance and the goal was exclusively to lengthen the limbs. However, this often resulted in limbs of adequate length but stiff or poorly functional.
Over the years, it has been understood that before lengthening a limb, it is essential to restore good joint morphology to optimize functionality and limit lengthening complications.
This is why the SUPER- procedures were developed.
SUPERAnkle Surgery: What does it involve?
The SUPERAnkle procedure aims to correct the ankle and foot in cases of congenital hypoplasia (fibular hemimelia, etc), making the ankle stable and the foot plantigrade, i.e. capable of resting on the ground at a 90° angle.
SUPERAnkle Surgery: Why Should You Do It?
In congenital hypoplasias there are various malformations that lead to a malformed ankle-foot segment with associated deformities.
Typically, there is an equinus deformity (toe pointing downwards) and valgus deformity (the foot is deviated outwards) which prevents the foot from being straightened and placed on the ground correctly or from being able to use braces easily or adequately.
In some cases the deviation may instead be equinus or varus, with foot deformities that resemble those of congenital clubfoot.
SUPERAnkle Surgery: Is It Always the Same Procedure?
Foot and ankle deformities are highly variable.
The ankle can vary from mild alterations with a small deviation, to severe malformations with complete absence of the fibula (agenesis).
The foot can be mildly affected, with an almost normal external appearance, or more severely affected (absence of one or more toes and metatarsals, fusion between bones, etc.).
The procedures to be performed will have to be adapted to the current situation: from simpler procedures to more complex interventions.
Experience is required to properly dose this procedure.
SUPER-Ankle surgery: at what age should it be performed?
We typically perform the surgery around age 2-3, before starting the limb lengthening program.
SUPER-Ankle Surgery: When to Plan Limb Lengthening?
Once the ankle-foot correction program has been completed, it is possible to schedule limb lengthening interventions: see the dedicated sheet.
If the lengthening program is approached without taking into account the ankle-foot deformities, there is an increased risk of complications (dislocations, stiffness, joint contractures) or of having a poor outcome at the end of the lengthening.
SUPER-Ankle Surgery: Is It Possible in Italy?
Until a few years ago, many families traveled abroad to undergo this procedure, facing grueling journeys, lengthy hospital stays, physiotherapy, and sometimes exorbitant expenses.
Fortunately, for several years now, these procedures have been available in Italy, significantly reducing costs and family commitments. In recent years, this trend has even reversed, with many patients coming from abroad to undergo this procedure at our center.