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Fibular Hemimelia Treatment, Symptoms, & Causes

Published: Jun 26, 2023
Fibular Hemimelia
Most of the time fibular hemimelia will be associated with foot & ankle problems along with leg shortening. It developed completely or part of the fibula is absent. Till now, no clear-cut cause (aetiology) has been defined for this problem.
Sometimes they may be associated with a defect in the femur and a deficiency of lateral foot rays. An infant will present with leg shortening, angulations of tibia, the partial or complete absence of fibula, and ankle deformity.
Drohr Paley has classified fibular hemimelia based on foot & ankle issues. Type 1 variety will have stable ankle joint, type 2 will have a dynamic valgus deformity.
Type 3 is further classified into four categories based on talocalcaneal issues. Treatment of Fibular hemimelia is based on the extent & type of foot deformity. In this surgical reconstruction, we need to excise the fibular analogue, supracondylar osteotomy for correction of the valgus ankle, maintenance of proper subtalar alignment & lengthening of the tibia by application of Ilizarov technique. Usually, this surgery is contemplated at the age of 1.5 years to 2 years.
The whole surgical procedure is known as super ankle surgery. A child may need second lengthening at the age of 7-8 years and final length equalization at 13 years of age. With the successful planning of surgery, a child can walk, run, and can do all activities.
With severe foot deformity child may need syme amputation at the ankle joint. Usually, we defer in doing the amputation. Because a child will need a prosthetic fitting for whole life. Maintenance & change of prosthesis will be required at regular intervals.
Trishla Foundation under the supervision of Dr Jitendra Kumar Jain, the pediatric orthopaedic surgeon has given a new lease of life to many children affected by Fibular hemimelia problems.

Authors

  • MS Ortho (PGI Chandigarh) & DNB Ortho, Senior Paediatric Orthopaedic Surgeon, Chairman of Trishla Foundation, India Experience of 20 years in children with orthopaedic problems, cerebral palsy & congenital limb deficiency. Manage more than 1 Lac children with Cerebral Palsy & orthopaedic problem. Member of different Government & non-government organizations. Cerebral palsy children from every state of India & 20 countries are visiting him for expert opinions.

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  • MBBS, MD (Community Medicine), PhD Public Health Secretary, Trishla Foundation, 15 years experience in counselling & guidance to parents of children with cerebral palsy

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