What is Tibial Hemimelia: Tibia hemimelia is a rare congenital lower limb deficiency presenting with a wide spectrum of associated congenital anomalies, deficiency & duplication. It present with a wide range of pathology ranging from a hypoplastic tibia to complete absence of the tibia. The fibula is always present, may be normal, dysplastic or duplicate. Incidence of tibial hemimelia is reported to be one per million live births.
Causes of Tibial Hemimelia: It is congenital anomaly, present since birth. Genetic causes are primary factor, otherwise in most of the cases causes are unknown
Symptoms of Tibial Hemimelia: Tibial Hemimelia can present in variety of manner like from shortening to complete absence of tibia. Symptoms are depends upon severity and type of tibial hemimelia. In smaller tibia, foot will be inward bend but as severity of tibial deficiency increases, grade of foot deformity increase. Few segment of toes can be absent along with sever equinus deformity of ankle, fibula will be protruding beyond knee and ankle join Child will not be able to bear weight on affected limb etc.
How Tibial Hemimelia can be diagnosed: Tibial Hemimelia can be easily diagnosed by just looking on leg deformity at time of birth but confirmation require X-ray of leg.
Classification of Tibial Hemimelia: Many classification of Tibial Hemimelia has been done but Paley classification is most use full classification as per treatment protocol is concerned.
Tests needed for Tibial Hemimelia: Some time it is also necessary to check other associated congenital anamoly so X-ray of whole extremity is needed. Some time MRI is needed to see un-ossified tibial segment.
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Dr. Jitendra Kumar Jain
Trishla Orthopedic Clinic & Rehab center, 182C / 350A, Tagore Town, Prayagraj (Allahabad) U.P-211002, India