Presentation
Lower limb length discrepancy and abnormal gait.
Patient Data
Age: 10 years
Gender: Male
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Info
- incomplete fusion of the posterior neural arch of S1 vertebra
- right coxa vara
- abnormal remodeling of lower ends of both femori
- complete absence of both fibulae
- abnormal bone remodeling of the upper end of the right tibia
- dysplastic both knee joints
- left genu varus
- talipes calcaneovalgus of the left foot
- oligodactyly and syndactyly of the right foot toes
- horizontal sclerotic lines are seen within both femori, likely of previous intervention
Case Discussion
Fibular hemimelia is a congenital lower limb anomaly characterized by a partial or a complete absence of the fibula. Although rare in occurrence, it is the most common congenital absence of long bone of the extremities.
Fibular hemimelia is usually obvious at birth with limb shortening and limb-length discrepancy. Syndactyly, oligodactyly or polydactyly may also be present.
Different classification systems have been developed. One of them is Achterman-Kalamchi classification which depends on the morphology of the fibula 1:
- type 1, the fibula is present but hypoplastic
- type 2, it is completely absent
So, our case is classified as Achterman-Kalamchi type II.
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