What Is Fibular Hemimelia and How is it Fixed?

Fibular Hemimelia is when someone is born with a partial or complete absence of the fibula, which makes their leg shorter and may include deformities the femur, knee, tibia and other foot and ankle conditions.

We don’t know what causes Fibular Hemimelia, but it is not considered to be genetic (passed down from the parents).

(image by orthobullets.com)

For many years amputation has been considered the standard treatment. If someone has a serious lack of ankle stabilization and significant limb length difference, then amputation is still recommended. There are two types of amputation methods used: the Boyd procedure and the Symes procedure.

However, advances in ankle reconstruction and limb lengthening are now an option for less sever cases of Fibular Hemimelia. There are many factors that decide which treatment option is the best choice.

When trying to decide between amputation or limb lengthening, parents would be wise to consult a foot and ankle specialist.

Basically, the main question to ask  is: “Is the foot functional?”

If the foot is not functional, then amputation and prosthetic fitting may be the best course. As horrible as that may sound to parents, keep in mind that even athletes have had this procedure and gone onto the Olympics.

That said, patients with less severe Fibular Hemimelia may undergo successful lengthening and stabilization procedures. Complex surgery for lengthenings is required to protect the foot from further deformity.

There have been studies that demonstrate that children who undergo early amputation are more active, have less pain, are more satisfied, have fewer complications, undergo fewer procedures, and incur less cost than those who undergo lengthening.

There were fewer hospital admissions, clinic visits, and periods of absence from school in children who had the amputation procedure done.

When it comes to limb lengthening, families often have unrealistic expectations of the surgical and prosthetic technology available and may refuse amputation, when this has been recommended, and instead choose limb lengthening.

The good news is that Fibular Hemimelia can be discovered via ultrasound while the baby is still in the mother’s uterus. This gives the parents and their foot and ankle doctor time to prepare for amputation after birth or bone lengthening surgery.

Here are a few interesting facts about Fibular Hemimelia:

  • Partial or total absence of fibula is one of the most frequent abnormalities in the legs.
  • It is most common long bone deficiency and is the most common skeletal deformity in the leg.
  • It most often is present only on one leg.
  •  Males have it twice as often as females.

If you suspect your child has Fibular Hemimelia, then a foot and ankle surgeon can give you the best course of action.

Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist and find out which is the best option for your child.

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