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Fibular Hemimelia: Multimedia

Author: Michael C Holmstrom, MD, Consulting Surgeon, Department of Orthopedics, The Orthopedic Specialty Hospital (TOSH)
Coauthor(s): Peter M Stevens, MD, Professor, Director of Pediatric Orthopedic Fellowship Program, Department of Orthopedics, University of Utah School of Medicine
Contributor Information and Disclosures

Updated: Aug 14, 2008

Multimedia

Type 1B fibular hemimelia in a 3-year-old boy. Th...
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Media file 1: Type 1B fibular hemimelia in a 3-year-old boy. The fibula is short relative to the tibia, and the tibia is shorter on the affected side. Note that the tibia is also mildly bowed. Image courtesy of Dennis P. Grogan, MD.
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Type 1B fibular hemimelia in a 3-year-old boy. Th...

Type 1B fibular hemimelia in a 3-year-old boy. The fibula is short relative to the tibia, and the tibia is shorter on the affected side. Note that the tibia is also mildly bowed. Image courtesy of Dennis P. Grogan, MD.

Fibular hemimelia in the same patient as in Image...
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Media file 2: Fibular hemimelia in the same patient as in Image 1. By the age of 5 years, the limb-length discrepancy is progressive and significant. Image courtesy of Dennis P. Grogan, MD.
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Fibular hemimelia in the same patient as in Image...

Fibular hemimelia in the same patient as in Image 1. By the age of 5 years, the limb-length discrepancy is progressive and significant. Image courtesy of Dennis P. Grogan, MD.

Type 2 fibular hemimelia (complete absence) in a ...
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Media file 3: Type 2 fibular hemimelia (complete absence) in a 1-year-old girl. Note that the foot is in a significant valgus position. Image courtesy of Dennis P. Grogan, MD.
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Type 2 fibular hemimelia (complete absence) in a ...

Type 2 fibular hemimelia (complete absence) in a 1-year-old girl. Note that the foot is in a significant valgus position. Image courtesy of Dennis P. Grogan, MD.

Fibular hemimelia. A ball-and-socket ankle joint ...
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Media file 4: Fibular hemimelia. A ball-and-socket ankle joint is a common finding in patients with fibular hemimelia. In and of itself, this is usually not problematic, but it is commonly associated with limb-length discrepancy and tarsal coalition. Image courtesy of Dennis P. Grogan, MD.
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Fibular hemimelia. A ball-and-socket ankle joint ...

Fibular hemimelia. A ball-and-socket ankle joint is a common finding in patients with fibular hemimelia. In and of itself, this is usually not problematic, but it is commonly associated with limb-length discrepancy and tarsal coalition. Image courtesy of Dennis P. Grogan, MD.

Type 2 fibular hemimelia (complete absence) in a ...
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Media file 5: Type 2 fibular hemimelia (complete absence) in a 4-month-old girl. Note the skin dimple in the midtibial area and the 2-ray foot. Image courtesy of Dennis P. Grogan, MD.
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Type 2 fibular hemimelia (complete absence) in a ...

Type 2 fibular hemimelia (complete absence) in a 4-month-old girl. Note the skin dimple in the midtibial area and the 2-ray foot. Image courtesy of Dennis P. Grogan, MD.

Fibular hemimelia. The radiographic appearance of...
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Media file 6: Fibular hemimelia. The radiographic appearance of the patient in Image 5. The fibula is absent, and the proximal tibial ossification center is absent. Two metatarsals are associated with 3 phalanges, 2 of which are fused to form only 2 toes. Image courtesy of Dennis P. Grogan, MD.
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Fibular hemimelia. The radiographic appearance of...

Fibular hemimelia. The radiographic appearance of the patient in Image 5. The fibula is absent, and the proximal tibial ossification center is absent. Two metatarsals are associated with 3 phalanges, 2 of which are fused to form only 2 toes. Image courtesy of Dennis P. Grogan, MD.

Type 1A fibular hemimelia in an 8-year-old boy. S...
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Media file 7: Type 1A fibular hemimelia in an 8-year-old boy. Significant valgus hindfoot is due to the shortened fibula. Image courtesy of Dennis P. Grogan, MD.
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Type 1A fibular hemimelia in an 8-year-old boy. S...

Type 1A fibular hemimelia in an 8-year-old boy. Significant valgus hindfoot is due to the shortened fibula. Image courtesy of Dennis P. Grogan, MD.

Type 2 fibular hemimelia and a significant anteri...
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Media file 8: Type 2 fibular hemimelia and a significant anterior bow to the tibia in a 9-month-old boy. Image courtesy of Dennis P. Grogan, MD.
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Type 2 fibular hemimelia and a significant anteri...

Type 2 fibular hemimelia and a significant anterior bow to the tibia in a 9-month-old boy. Image courtesy of Dennis P. Grogan, MD.

Fibular hemimelia in the same patient as in Image...
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Media file 9: Fibular hemimelia in the same patient as in Image 8. Because the tibial bowing caused prosthetic fitting problems, corrective osteotomy was performed. Image courtesy of Dennis P. Grogan, MD.
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Fibular hemimelia in the same patient as in Image...

Fibular hemimelia in the same patient as in Image 8. Because the tibial bowing caused prosthetic fitting problems, corrective osteotomy was performed. Image courtesy of Dennis P. Grogan, MD.

Type 1B fibular hemimelia in an 8-year-old boy. T...
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Media file 10: Type 1B fibular hemimelia in an 8-year-old boy. The limb-length discrepancy is 6 cm. The patient is undergoing tibial lengthening with a unilateral external fixation device. Image courtesy of Dennis P. Grogan, MD.
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Type 1B fibular hemimelia in an 8-year-old boy. T...

Type 1B fibular hemimelia in an 8-year-old boy. The limb-length discrepancy is 6 cm. The patient is undergoing tibial lengthening with a unilateral external fixation device. Image courtesy of Dennis P. Grogan, MD.

Fibular hemimelia. A 10-year-old girl is undergoi...
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Media file 11: Fibular hemimelia. A 10-year-old girl is undergoing lengthening of her tibia with an Ilizarov device. The device incorporates her foot to maintain the position of the foot during lengthening with a lift. This device can be adjusted as lengthening proceeds and as the discrepancy decreases. Image courtesy of Dennis P. Grogan, MD.
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Fibular hemimelia. A 10-year-old girl is undergoi...

Fibular hemimelia. A 10-year-old girl is undergoing lengthening of her tibia with an Ilizarov device. The device incorporates her foot to maintain the position of the foot during lengthening with a lift. This device can be adjusted as lengthening proceeds and as the discrepancy decreases. Image courtesy of Dennis P. Grogan, MD.

Fibular hemimelia. This specimen was removed at t...
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Media file 12: Fibular hemimelia. This specimen was removed at the time of Syme amputation in a patient with fibular hemimelia and significant limb-length discrepancy, prior to prosthetic fitting. Note the separate ossification centers for the talus and calcaneus, but no joint space is evident. Image courtesy of and copyright held by Grogan DP, Holt GR, Ogden JA. Talocalcaneal coalition in patients who have fibular hemimelia or proximal femoral focal deficiency: a comparison of the radiographic and pathological findings. J Bone Joint Surg Am 1994;Sep 76(9):1363-70.
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Fibular hemimelia. This specimen was removed at t...

Fibular hemimelia. This specimen was removed at the time of Syme amputation in a patient with fibular hemimelia and significant limb-length discrepancy, prior to prosthetic fitting. Note the separate ossification centers for the talus and calcaneus, but no joint space is evident. Image courtesy of and copyright held by Grogan DP, Holt GR, Ogden JA. Talocalcaneal coalition in patients who have fibular hemimelia or proximal femoral focal deficiency: a comparison of the radiographic and pathological findings. J Bone Joint Surg Am 1994;Sep 76(9):1363-70.

Fibular hemimelia. Clinical photograph of the spe...
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Media file 13: Fibular hemimelia. Clinical photograph of the specimen shown in Image 12. Note that the ossification centers are actually part of 1 solid cartilaginous anlage. The 2 separate ossification centers fuse during adolescence, and only then is the tarsal coalition radiographically evident. Image courtesy of and copyright held by Grogan DP, Holt GR, Ogden JA. Talocalcaneal coalition in patients who have fibular hemimelia or proximal femoral focal deficiency: a comparison of the radiographic and pathological findings. J Bone Joint Surg Am 1994;Sep 76(9):1363-70.
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Fibular hemimelia. Clinical photograph of the spe...

Fibular hemimelia. Clinical photograph of the specimen shown in Image 12. Note that the ossification centers are actually part of 1 solid cartilaginous anlage. The 2 separate ossification centers fuse during adolescence, and only then is the tarsal coalition radiographically evident. Image courtesy of and copyright held by Grogan DP, Holt GR, Ogden JA. Talocalcaneal coalition in patients who have fibular hemimelia or proximal femoral focal deficiency: a comparison of the radiographic and pathological findings. J Bone Joint Surg Am 1994;Sep 76(9):1363-70.

More on Fibular Hemimelia

Overview: Fibular Hemimelia
Workup: Fibular Hemimelia
Treatment: Fibular Hemimelia
Follow-up: Fibular Hemimelia
Multimedia: Fibular Hemimelia
References
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References

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Further Reading

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Keywords

fibular hemimelia,  fibular hypoplasia, fibula hypoplasia, fibula aplasia, fibular aplasia, fibular abnormality, postaxial hypoplasia of the lower extremity, limb-length discrepancy, postaxial hypoplasia of the lower extremity, amelia, phocomelia, ectromelia, sirenomelia

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Contributor Information and Disclosures

Author

Michael C Holmstrom, MD, Consulting Surgeon, Department of Orthopedics, The Orthopedic Specialty Hospital (TOSH)
Michael C Holmstrom, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, Arthroscopy Association of North America, Pediatric Orthopaedic Society of North America, and Utah Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Peter M Stevens, MD, Professor, Director of Pediatric Orthopedic Fellowship Program, Department of Orthopedics, University of Utah School of Medicine
Peter M Stevens, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Limb Lengthening and Reconstruction Society ASAMI-North America, Pediatric Orthopaedic Society of North America, Utah Medical Association, and Western Orthopaedic Association
Disclosure: Orthofix Inc Royalty Independent contractor

Medical Editor

Dennis P Grogan, MD, Clinical Professor, Department of Orthopedic Surgery, University of South Florida College of Medicine; Chief of Staff, Department of Orthopedic Surgery, Shriners Hospital for Children of Tampa
Dennis P Grogan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Eastern Orthopaedic Association, Irish American Orthopaedic Society, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Thomas M DeBerardino, MD, Associate Professor of Orthopaedic Surgery, University of Connecticut Health Center
Thomas M DeBerardino, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, and American Orthopaedic Society for Sports Medicine
Disclosure: Arthrex, Inc. Grant/research funds Other; Arthrex, Inc. Honoraria Speaking and teaching; Genzyme Biosurgery. Inc. Grant/research funds Other; Musculoskeletal Transplant Foundation Grant/research funds Other; Histogenics Grant/research funds None; Arthrex, Inc. Consulting fee Speaking and teaching

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Carlos J Lavernia, MD, FAAOS, Adjunct Clinical Professor, Department of Orthopedic Surgery, University of Miami School of Medicine; Medical Director, Orthopedic Institute at Mercy Hospital
Carlos J Lavernia, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons, Arthritis Foundation, Biomedical Engineering Society, Florida Orthopaedic Society, and Orthopaedic Research Society
Disclosure: Zimmer Stock Implant Designer

 
 
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