Also known as congenital absence of the fibula, congenital fibular deficiency, paraxial fibular hemimelia and aplasia/hypoplasia of the fibula, fibular hemimelia . Fibular hemimelia. Disease definition. Fibular hemimelia is a congenital longitudinal limb deficiency characterized by complete or partial absence of the fibula. consists of shortening or entire absence of the fibula; previously known as fibular hemimelia; the most common congenital long bone deficiency.

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Dorsiflexion is limited by the short neck of the talus and its impingement with the neck due to the lack of talar neck offset concavity.

These three wires are parallel to fibylar sole fobular the foot. Foot Deformity Patient with Fibulaf during treatment The foot deformity is one of the biggest issues with fibular hemimelia. FH occurs in between 1: The foot is fixed with three wires; the first calcaneal wire enters postero-midline in the calcaneus to exit between the first and second toes.

In particular, the anterior cruciate ligament ACL is often under-developed hypoplastic or absent. Congenital longitudinal deficiency of the fibula fibular hemimelia: Tibial deformity There is often a mild to severe diaphyseal tibial deformity of the valgus-procurvatum.

Neither the parents of the child with FH nor the child themselves have any increased risk of producing additional children with this or other birth defects. Complete fibrous anlage resection may reduce the frequency and degree of rebound but has not eliminated the problem.


Hallux varus, syndactaly and conjoint delta first metatarsals are the most common toe deformities associated with FH that benefit from surgical treatment of the toes.

The proximal osteotomy is parallel to the proximal sagittal plane fibuar wire 4.

Fibular Hemimelia

A single small dose of amitriptyline before bedtime is useful in helping these patients. Toe and metatarsal surgery Many patients with FH are missing one or more toes. Knee ligament reconstruction Most patients with FH have some hemimeliw ligament deficiency of the cruciate ligaments. Thus, even three such reconstructions cost less than the lifetime cost per amputee.

Fibular Deficiency (anteromedial bowing) – Pediatrics – Orthobullets

The foot deformity is one of the biggest issues with fibular hemimelia. For more information on the etiology and treatment of fibular hemimelia, please see our Fibular Hemimelia FAQ.

Other bones in the leg, ankle, and hemiimelia can be affected too. Complications occurred in nine of the ten cases, and all were all resolved either surgically or nonoperatively.

Orphanet: Fibular hemimelia

This is performed anywhere in the proximal tibia distal to the proximal pins. Satisfactory results were achieved in all except one of the patients with mild FH, a patient who had a rigid equino-valgus foot. Children with fibular hemimelia are missing part or all of their fibula and this bump may be completely missing. The fibular anlage is exposed. Madelung’s deformity Clinodactyly Oligodactyly Polydactyly.


The buttress of the fibula is replaced by the varusized tibial plafond, since the lateral plafond is now more distal than the medial plafond. This valgus is related both to the distal femur and the proximal tibia.

The tibial diaphysis hemijelia an antero-lateral bow. Congenital absence of the fibula. Vascular dysgenesis, viral infections, trauma and environmental influences have been suggested as possible causes. The peroneal sheath is opened.

Fibular Deficiency (anteromedial bowing)

Open in a separate window. Biomechanical principles related to FH reconstructive surgery The normal ground reaction jemimelia vector passes lateral to the center of the tibial plafond and talus because the point of contact of the calcaneus with the ground is lateral to the center of the ankle hemmimelia [ 22 ], resulting in a valgus moment arm on the ankle joint. It is therefore part of the same spectrum of deficiency as congenital femoral deficiency.

Principles of deformity correction, 1st edn, corrected 3rd printing. Sabharwal S ed Pediatric lower limb deformities. Growth inhibition has been reported after tibial lengthening for FH [ 30 ].

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