Fibular Hemimelia Content Area Fibular hemimelia is a birth defect where part or all of the fibular bone is missing, as well as associated limb length discrepancy, foot deformities, and knee deformities. Fibular hemimelia FH is a very rare disorder, occurring in only 1 in 40, births. Bilateral fibular hemimelia affecting both legs is even rarer. It is currently unknown why fibular hemimelia occurs. Research has demonstrated that if the genes guiding the formation of the limb are activated in an abnormal order, fibular hemimelia can occur.
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Children who have fibular hemimelia are born with a short or missing fibula one of the two bones in the lower leg. Other bones in the leg, ankle, and foot can be affected too. Experts who treat bone problems have several options to help kids with a hemimelia. Here are some of the things that parents might see when a baby is born with hemimelia: When all or some of the bone is missing in one leg, the leg is shorter than the other.
Doctors call this a leg length discrepancy. Because the shinbone is short or missing, the ankle joint may not form as it should. The ankle and foot might look different from normal. The foot may not have all five toes. Doctors can find these through physical exams and tests: The hip joint may be too shallow.
Some of the ligaments strong, flexible bands of tissue that hold the knee together may be weak or missing. What Causes Fibular Hemimelia? But they do know that nothing a mom does during pregnancy causes the problem. How Is Fibular Hemimelia Diagnosed? Often, doctors know that a fibula is short or missing before a baby is born. They may order these tests to learn more: X-rays will show what the bones and joints look like. MRIs will let doctors see ligaments and other soft tissue in the foot and joints.
How Is Fibular Hemimelia Treated? Treatment depends on how the child is affected. Some children with fibular hemimelia have very mild limb length difference and need very little treatment.
Others have a large limb length difference and unstable joints. When a child has fibular hemimelia, the leg may not grow as fast or as long as it should. Kids might have trouble standing or walking. Getting the right treatment is important. Different experts work as a team to treat fibular hemimelia. The team is led by specialists doctors and other health care providers who treat bone and muscle problems.
They work with other specialists as needed. The care team will come up with a plan to help your child stand, walk, and play like other kids. The plan is based on: how much bone is missing how much difference there is in the length of the legs how the problem might affect your child as he or she grows whether your child has foot or ankle problems You might need to bring your child for a series of visits over several months before the care team decides on treatment.
This gives the team time to understand how your child will grow and what the difference in leg length might be. But most kids need surgery.
Most kids get surgery to help their legs grow to the same length. Others need surgery to stand and walk. Some kids only need one surgery. Others have several surgeries during their growing years. Epiphysiodesis When kids have small differences in leg length, the care team might suggest a surgery called epiphysiodesis eh-pih-fiz-ee-AH-deh-sis. For this surgery to work, kids must still be growing.
During the surgery, one or two of the growth plates in the longer leg are scraped or compressed with surgical plate and screws. A growth plate is an area at the end of the bone where new growth happens. The surgery slows or stops the longer leg from growing so the shorter leg can catch up. Leg-Lengthening Surgery Kids who get leg-lengthening surgery usually need a few operations over several years. The surgery can add about 8 inches 20 centimeters to the shorter leg.
In this surgery, the orthopedic team places a lengthening device on the shorter leg. The device might be on the outside of the body or inside the bone. Other Surgeries Besides surgery to fix leg length differences, some kids need surgery to help them stand and walk.
For these kids, a offers the best chance to live an active life. Doctors might amputate do surgery to remove part of the foot or leg so the child can wear a prosthesis. Orthotists then fit the child with a prosthetic lower leg. New prosthetics let kids who have had an amputation run, climb, and jump like other kids. Most kids can play sports. Kids who wear prosthetic legs need to see an orthotist at least once a year.
The orthotist will adjust the prosthesis or make a new one as the child grows. How Can Parents Help? Helping children with fibular hemimelia reach their full potential takes many years. Kids need medical care until they are done growing. Because of this, doctors want parents to play a big role in treatment.
Ask questions. Find out what each surgery is for and how to care for your child after them. Take your child to all medical visits. If your child is old enough, talk about treatments and what to expect. Include older kids in surgery decisions when you can.
Perna mais curta que a outra: causas e tratamento
Children who have fibular hemimelia are born with a short or missing fibula one of the two bones in the lower leg. Other bones in the leg, ankle, and foot can be affected too. Experts who treat bone problems have several options to help kids with a hemimelia. Here are some of the things that parents might see when a baby is born with hemimelia: When all or some of the bone is missing in one leg, the leg is shorter than the other. Doctors call this a leg length discrepancy. Because the shinbone is short or missing, the ankle joint may not form as it should.
Bones of human lower extremity Characteristics are: A fibrous band instead of the fibula Short deformed leg Absence of the lateral part of the ankle joint due to absence of the distal end of the fibula , and what is left is unstable; the foot has an equinovalgus deformity Possible absence of part of the foot requiring surgical intervention to bring the foot into normal function, or amputation. Possible absence of one or two toes on the foot Possible conjoined toes or metatarsals Partial or total absence of fibula is among the most frequent limb anomalies. It is the most common long bone deficiency and is the most common skeletal deformity in the leg. It most often is unilateral present only on one side. It may also present as bilateral affecting both legs. Paraxial fibular hemimelia is the most common manifestation in which only the postaxial portion of the limb is affected. It is commonly seen as a complete terminal deficiency, where the lateral rays of the foot are also affected.