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fibular hemimelia

Dror Paley
Fibular hemimelia presents with foot deformity and leg length discrepancy. Previous classifications have focused on the degree of fibular deficiency rather than the type of foot deformity. Published methods of surgical reconstruction have often failed due to residual or recurrent foot deformity. The purpose of this report is to introduce new classification and reconstruction methods. The Paley SHORDT procedure is used to stabilize the ankle when there is a hypoplastic distal fibula with a dynamic valgus deformity...
December 2016: Journal of Children's Orthopaedics
Nathaly Quintero-Prigent, Caroline Radot, Marion Fiat, Malak Fahny, Naima Brennetot
OBJECTIVE: Fibular hemimelia or longitudinal fibular deficiency is the most frequent congenital malformation of lower limbs. It causes sometimes major limbs shortening. Different treatments could be considered depending on the severity of the malformation: contralateral epiphysiodesis, corrective foot and knee osteotomies, leg-lengthening surgery with external fixation, prosthesis. For the most severe cases (15-20cm bone length discrepancies or unstable knee or foot), leg-lengthening surgery with external fixation is not recommended...
September 2016: Annals of Physical and Rehabilitation Medicine
Shiel Jhaveri, Amir Mahajer, Dennis H Horn
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Kenichi Mishima, Hiroshi Kitoh, Koji Iwata, Masaki Matsushita, Yoshihiro Nishida, Tadashi Hattori, Naoki Ishiguro
Fibular hemimelia is a rare but the most common congenital long bone deficiency, encompassing a broad range of anomalies from isolated fibular hypoplasia up to substantial femoral and tibial shortening with ankle deformity and foot deficiency. Most cases of fibular hemimelia manifest clinically significant leg length discrepancy (LLD) with time that requires adequate correction by bone lengthening for stable walking. Bone lengthening procedures, especially those for pathological bones, are sometimes associated with severe complications, such as delayed consolidation, fractures, and deformities of the lengthened bones, leading to prolonged healing time and residual LLD at skeletal maturity...
May 2016: Medicine (Baltimore)
P Pallavee, Rupal Samal, Jasmina Begum, Seetesh Ghose
Misoprostol is a well known abortifacient. It can cause teratogenicity like Mobius sequence and terminal transverse limb defects. We report a rare case of proximal focal femoral deficiency with fibular hemimelia in a woman who had attempted abortion with self-administered misoprostol and later continued the pregnancy. Though the absolute risk of congenital malformations with its use is low ∼1%, this should be clearly communicated to the women requesting abortion to help them make fully informed reproductive health decisions...
August 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Samuel Sisay, Daniel Admassie
Fibular hemimelia is a rare congenital absence of the fibula that may occur as an isolated anomaly or as a part of a malformation syndrome. Shortening of the extremity is obvious at birth with leg-length discrepancy. On plain radiograph of the leg and foot, significant deficiency or absence of the fibula can be seen. In this case report, a 6 year old boy with fibular hemimelia is presented. Radiological diagnosis and differential diagnosis are discussed.
July 2015: Ethiopian Medical Journal
Jothi Murali, Keith Monchik, Paul Fadale
The incidence of congenital absence of the anterior cruciate ligament (ACL) is extremely low. Congenital ACL absence has most often been found in association with conditions such as knee dislocation, knee dysplasia, proximal focal femoral deficiency, and fibular hemimelia. We report on the incidental finding of ACL aplasia in a patient with a medial meniscal tear and history of leg-length discrepancy. As has been found in prior case studies, this patient had hypertrophy of the meniscofemoral ligament of Humphrey, which likely lent her stability...
August 2015: American Journal of Orthopedics
Maria A Bedoya, Nancy A Chauvin, Diego Jaramillo, Richard Davidson, B David Horn, Victor Ho-Fung
Congenital lower limb shortening is a group of relatively rare, heterogeneous disorders. Proximal focal femoral deficiency (PFFD) and fibular hemimelia (FH) are the most common pathologic entities in this disease spectrum. PFFD is characterized by variable degrees of shortening or absence of the femoral head, with associated dysplasia of the acetabulum and femoral shaft. FH ranges from mild hypoplasia to complete absence of the fibula with variable shortening of the tibia. The development of the lower limb requires complex and precise gene interactions...
July 2015: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Pedro C Cavadas, Alessandro Thione
Fibular hemimelia, or fibular hypoplasia-aplasia, is the most frequent congenital long-bone deficiency. There is still some debate on reconstruction versus amputation for the severe type Ib and type II cases. Limb-length discrepancy can be corrected with Ilizarov methods, but ankle stability remains a problem. The absence of the lateral malleolus destabilizes the mortise in valgus and ankle fusion is usually needed. A case of lateral malleolus reconstruction in a teenage patient with severe type-Ib fibular hemimelia using a contralateral free proximal fibular epiphyseal transfer is reported...
July 2015: Journal of Pediatric Orthopedics. Part B
A Bergère, E Amzallag-Bellenger, G Lefebvre, A Dieux-Coeslier, A Mezel, B Herbaux, N Boutry
Lower limb malformations are generally isolated or sporadic events. However, they are sometimes associated with other anomalies of the bones and/or viscera in patients with constitutional syndromes or disorders of the skeleton. This paper reviews the main imaging features of these abnormalities, which generally exhibit a broad spectrum. This paper focuses on several different bone malformations: proximal focal femoral deficiency, congenital short femur and femoral duplication for the femur, tibial hemimelia (aplasia/hypoplasia of the tibia) and congenital bowing for the tibia, fibular hemimelia (aplasia/hypoplasia) for the fibula, and aplasia, hypoplasia and congenital dislocation for the patella...
September 2015: Diagnostic and Interventional Imaging
Erika Rae Larson
BACKGROUND: Individuals with lower limb amputation (LLA) commonly experience low back pain (LBP). Although massage effects on LBP are well-documented, research regarding massage for individuals with LLA is scarce. OBJECTIVES: This study evaluated the effectiveness of massage therapy to promote activity level, decrease LBP, and improve health-related quality of life (HRQOL) in a long-term prosthetic user. METHODS: The 50-day study consisted of two baseline sessions, seven treatment sessions that included a 50-min massage applied to major gait muscles, and two follow-up sessions...
April 2015: Journal of Bodywork and Movement Therapies
Arnold Popkov, Anna Aranovich, Dmitry Popkov
PURPOSE: This study aimed to evaluate development of the tibia after Ilizarov lengthening and deformity correction depending on whether or not the simultaneous resection of fibular anlage was performed in children with fibular aplasia type II, who did not undergo early surgery. METHODS: The study analyses results of reconstructive treatment in 38 children at the age of over four years. Two groups of children are compared: bifocal tibial lengthening with the Ilizarov device (group I) and bifocal lengthening associated with resection of the fibular anlage (group II)...
July 2015: International Orthopaedics
Akifusa Wada, Tomoyuki Nakamura, Noriko Urano, Hideaki Kubota, Yutaka Oketani, Mayuki Taketa, Toshio Fujii
Nineteen foot centralizations were performed in 14 patients with Jones type I and II tibial hemimelia. All feet showed equinovarus deformity and were treated by foot centralization by means of calcaneofibular arthrodesis. The average age of patients at the time of surgery was 1.3 years (range 0.4-3.8 years). The average follow-up postoperative period was 10.2 years (range 2.2-22.9). At the time of the final follow-up, four of the operated feet were plantigrade without secondary surgery. The remaining 15 limbs, however, required secondary surgery to treat postoperative early loss of correction and/or recurrent foot deformities such as equinus, varus and adduction, in addition to talipes calcaneal deformities, and fibular angular deformity at the fibular shortening osteotomy site...
March 2015: Journal of Pediatric Orthopedics. Part B
Sherif N G Bishay
PURPOSE: The combination of fibular hemimelia with congenital short femur worsens the limb length discrepancy which requires extensive femoral and tibial lengthening. PATIENTS AND METHODS: Eight patients having unilateral lower extremity shortening presented to the National Institute of Neuromotor System, Egypt, between September 2008 and September 2010 and underwent single session femoral and tibial lengthening using Ilizarov ring external fixator technique. Consolidation of the femoral and tibial required length gain was evident in the radiographic follow-up...
December 2014: Journal of Orthopaedics
Prangthong Unprasert, Kamolporn Kaewpornsawan, Chatupon Chotigavanichaya, Perajit Eamsobhana
BACKGROUND: Fibular hemimelia is one of the most common congenital longitudinal bone deficiencies. Previous treatment protocols called for amputation of the deficient limb; while others made attempts to save the limb. The objective of treatment is to restore function and achieve patient satisfaction. The authors evaluated the outcomes of the Ilizarov technique for the treatment of leg-length discrepancy and bone associated deformities in patients with fibular hemimelia. The present study also evaluated and assessed complications, knee and ankle function, and patient satisfaction with the treatment...
September 2014: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Christof Radler, Abigail K Myers, Renee J Hunter, Pedro P Arrabal, John E Herzenberg
OBJECTIVES: Routine ultrasonography can detect congenital femoral deficiency (CFD) and fibular hemimelia (FH), but prenatal detection rate and its relation to deformity severity have never been reported. Whether mothers prefer prenatal diagnosis is also unknown. We aimed to determine whether mothers prefer prenatal diagnosis, to report detection rates for CFD and/or FH, and to correlate detection rates to severity of limb shortening. METHODS: Surveys were mailed to 171 mothers who gave birth to children with CFD/FH between 2000 and 2008...
October 2014: Prenatal Diagnosis
E López-Gavito, P Parra-Téllez, J Ortiz-Garza, J Vázquez-Escamilla
Pirogoff amputation was originally described by Russian surgeon Nicholas Pirogoff in 1864. It refers to the osteoplastic amputation distal to the ankle joint, talus resection and bone fusion of the tibia and the calcaneus. Its advantages are as follows: less loss in limb length, the possibility of full weight bearing, and the use of a more anatomical prosthesis. We present herein two cases: a 38 year-old female patient who underwent Chopart amputation after a gunshot wound and developed a plantar flexion deformity that prevented proper use of the prosthesis; and a 39 year-old male with sequela of fibular hemimelia, with severe foot deformity preventing proper use of the extremity and footwear...
November 2012: Acta Ortopédica Mexicana
Philip Yoong, Ramy Mansour
BACKGROUND: Fibular hemimelia is a rare bone dysplasia with partial or complete absence of the fibula. There are many associated lower limb deformities. METHODS: We describe the commonly associated bone and soft tissue abnormalities in the knee joint in a case series of six knees in five patients with fibular hemimelia who underwent both radiographic and MR imaging. RESULTS: In all knees, there was an elongated conjoint tendon of the lateral collateral ligament and biceps femoris...
June 2014: Knee
Lior Shabtai, Stacy C Specht, Shawn C Standard, John E Herzenberg
BACKGROUND: Patients with congenital limb shortening can present with joint instability, soft tissue contractures, and significant leg length discrepancy. Classically, lengthening is done with external fixation, which can result in scarring, pin site infection, loss of motion, and pain. We therefore developed an alternative to this approach, a new, controllable, internal lengthening device for patients with congenital limb shortening. QUESTIONS/PURPOSES: We evaluated this device in terms of (1) healing index, (2) complications, (3) accuracy of the device's external controller, and (4) adjacent-joint ROM...
December 2014: Clinical Orthopaedics and related Research
Randy Mascarenhas, David Simon, Brian Forsythe, Christopher D Harner
Fibular hemimelia exists as a rare cause of ACL insufficiency. This case report concerns the diagnosis and treatment of anterior cruciate ligament insufficiency in a teenage football player with fibular hemimelia. While ACL reconstruction has been described to allow activities of daily living in this patient population, this is the first report in the literature of anterior cruciate ligament reconstruction in an athlete with fibular hemimelia. We believe that ACL reconstruction is a viable and beneficial treatment option in the care of a symptomatic patient with congenital absence of the ACL and can allow athletes with this condition to return not only to their previous functional level, but also to their previous level of play...
March 2014: Knee
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