Fibular Hemimelia Treatment, Symptoms, and Causes
Fibular hemimelia is a congenital anomaly in which fibula is not developed completely or part of the fibula is absent. Till now, no clear cut cause (Aetiology) is defined for this problem. Most of the time fibular hemimelia will be associated with foot & ankle problem along with leg shortening. Sometimes they may be associated with a defect in femur and deficiency of lateral foot rays. An infant will present with leg shortening, angulations of tibia, the partial or complete absence of fibula, ankle deformity. Drohr Paley has classified fibular hemimelia on the basis of 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 on the basis of talocalcaneal issues. Treatment of Fibular hemimelia is based on extent & type of foot deformity. In this surgical reconstruction, we need to excise fibular analogue, supracondylar osteotomy for correction of valgus ankle, maintenance of proper subtalar alignment & lengthening of tibia by application of ilizarov technique. Usually, this surgery is contemplated at the age of 1.5 year to 2 year. Whole surgical procedure is known as super ankle surgery. A child may need second lengthening at the age of a 7-8 year and final length equalization at 13 year age. With the successful planning of surgery, a child can walk, run and can do all activity. With sever 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 requiring at regular interval. Trishla foundation under the supervision of Dr. Jitendra Kumar Jain, the pediatric orthopedic surgeon has given new lease of life in many children affected by Fibular hemimelia problem.