When a child is born with a portion or all of the fibula (leg bone) missing.
Understanding Fibular Hemimelia
Fibular hemimelia is a condition that causes part of the lower leg to be partially or completely absent. It is present from birth and may be seen during a routine ultrasound of the pregnant mother. There is no known cause of fibular hemimelia at this time, but visual symptoms include differences in leg length, inward or outward bowing of the lower leg, and missing toes on the affected foot.
Treatment of each child’s condition should be considered unique and individualized. Surgical options for this condition include amputation and limb lengthening procedures. The decision for surgical amputation or a limb lengthening depends on the extent of foot deformity, the limb length difference, and the wishes of the patient and their family. Surgical intervention may require multiple operations, at different ages, during the child’s period of growth. Additional bone and joint conditions may develop if this condition is untreated. Bracing or prosthetic leg options will depend on the length of the child’s leg and if surgery has happened.
Early orthotic/prosthetic treatment can provide better outcomes for the patient, including improvements in standing, balance, and walking. There may be a need for a brace to protect the limb after surgery. A prosthesis will be started for a child after the limb is fully healed. Evaluations, fittings, and follow-up care for a prosthesis are continuous throughout life.
Children fit with a brace or prosthesis are usually able to walk, run, play sports, and have an independent life. All patients with fibular hemimelia will require consistent follow-up visits as they continue through adolescence. These visits are necessary to provide follow-up care and identify when it is necessary to replace the brace or prosthesis as the child progresses through adolescence and into adulthood.
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