- Dwarka, ND and Gurugram , Haryana, India
Dr. Ratnav Ratan offers consultations and treatment on tibial hemimelia conditions in growing children. He is a consulting orthopedist in Gurgaon with varied experience in pediatric orthopedics and treating sports injuries.
A patient with an absent or a shortened tibia with an unaffected fibula is said to have tibial hemimelia. In cases of subtle deformities, the patient may have a duplication of the great toe.
Tibial hemimelia refers to deformities in the lower extremities and malformations in the foot.
Tibial hemimelia is a rare deformity and occurs in one out of one million live births.
It is detected through ultrasonography performed during or after the fourth month of pregnancy.
The line of treatment of tibial hemimelia requires critical decision-making regarding amputation versus reconstruction of the limb. Other factors that must be taken into account include the possibility of quadriceps functioning regarding extension of the knee joint.
Tibial hemimelia affects lower limb development and requires early orthopedic evaluation
Tibial hemimelia is associated with the following syndromes:
In cases of tibial hemimelia, the foot and the ankle are always pointing inwards, i.e. varus, while in fibular hemimelia, the foot and the ankle point outwards, i.e. valgus.
In tibial hemimelia, the deficiency progresses from ankle to knee, while in fibular hemimelia, the progression takes place from knee to ankle. This is the main defining feature that differentiates fibular hemimelia from similar conditions.
The treatment approach of tibial hemimelia includes surgery, amputation, and orthotic treatment as part of recovery and restoring limb mobility.
The orthopedic surgeon focuses on achieving a functional limb equal to the normal limb when the patient attains full growth.
The patient needs to have a functional, flat, stable, and flexible foot.
Hence, treating tibial hemimelia is customized as per the patient’s condition in consultation with a team of multidisciplinary experts.
All the associated anomalies and deformities should be screened and evaluated before proceeding with the surgical procedure.
Most patients diagnosed with tibial hemimelia need to undergo a surgical procedure to correct their deformity.
They may also need to wear customized splints or braces for mobility.
The extent or degree of quadriceps mechanism in these patients determines whether the limb with tibial hemimelia should be salvaged or amputated.
In most cases, projected limb length discrepancy along with reconstructive treatment has led to average results.
However, modern limb lengthening procedures have had desired results with some treatable complications.