How Can Tibial Hemimelia Be Corrected?

Tibial Hemimelia is not a city in Tibet. It is a leg and foot condition where there is a partial or total absence of the tibia (also known as the shinbone).

It is the rarest form of lower limb deficiency (present at birth) and only happens in one in a million births. This is a big deal because the Tibia is the strongest weight bearing bone in the body.

(photo by rbelding.org)

There are two long bones in the lower leg, the thicker one is called the Tibia and the thinner one is the Fibula. When a baby has Tibial Hemimelia, the Fibula is there, but the Tibia is either missing or misshapen.

There is often a foot deformity and the foot may even have additional toes. If that wasn’t enough, the knee may also be twisted inwards.

Most legs affected by Tibial Hemimelia will look unusual and it can happen in either in one leg or both legs. Thirty percent of the time with Tibial Hemimelia,  both legs have it.  Sometimes the Fibula may also be deformed or unaffected.

Tibial Hemimelia may be discovered when the baby is born or during a routine ultrasound. Treatment of the Tibial Hemimelia by  a foot and ankle surgeon really depends on how severe it is.

For a mild form of Tibial Hemimelia, the Ilizarov apparatus may be used to lengthen the baby or child’s leg and improve the position of the foot.

In more severe cases of Tibial Hemimelia, amputation may be the best option, followed by a prosthetic limb (fake leg), which may be placed above or below the knee depending on the condition of the knee joint.

Some attempts at reconstruction of the Tibia have been made using the Fibula, but this rarely provides a functioning limb because of instability at the knee and problems with the quadriceps (thigh) musculature.

Tibial Hemimelia is a type of Lower Limb Deficiency (LLD). The options for treatment of Tibial Hemimelia  will vary depending on which bones are present, the size and shape of them and any problems in other structures such as muscles and ligaments.

When considering Tibial Hemimelia treatment options for your child, it is important to remember there is not one ‘right’ or ‘wrong’ decision. Parents should never feel pressured into making any quick decisions, but should always have clear unbiased information.

If you child suffers from Tibial Hemimelia, then you need to contact a foot and ankle surgeon who can give you the best course of action for your child.

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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