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Tibial Hemimelia

Tibial hemimelia is a rare congenital malformation in which the tibia (the largest bone in the leg) is partially or completely absent. This causes shortening of the leg and can lead to several other deformities, such as knee instability and clubfoot.
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Tibial hemimelia is a congenital defect that predominantly affects the development of the main bone of the leg, the tibia.

It differs from fibular hemimelia in which the lateral leg bone, the fibula, is mainly involved.

What is tibial hemimelia?

Tibial hemimelia develops during pregnancy and is present at birth and is therefore a congenital deficieny.

It is a condition with highly variable severity, from very mild to very serious.

The tibia bone can be mildly affected with mild dysplasia or deformity, or more severely affected, with significant shortening or complete absence of the tibia (tibial agenesis).

Unfortunately, in tibial hemimelia, not only the bone is affected but also the other structures of the leg (joints, ligaments, muscles, vessels, etc.) and the foot.

A very important factor in defining the severity of tibial hemimelia is the involvement of the knee and ankle joints. Involvement can vary greatly, from minimally involved joints to laxity or instability of the knee or ankle that can be corrected through surgery, to severe malformations for which adequate function cannot be expected and one must be content with stable support of the limb in a functional position.

At the foot and ankle level, the involvement in cases of tibial hemimelia can be highly variable, from well-shaped feet to more or less severe cases of absent toes and metatarsals, to severe malformations of the ankle.

Tibial hemimelia may be associated with a foot deviation typical of congenital clubfoot.

Treatment of tibial hemimelia

Treatment of tibial hemimelia requires experienced centers. The treatment plan must take into account various aspects of the condition, especially:

  • limb shortening (involving one or more procedures to restore limb length)
  • problems of the knee and ankle joints, performing procedures to provide adequate stability and movement in the axis deviations.