report of five cases of paraxial fibular hemimelia with emphasis on conservative management

ABSTRACT

To elucidate the clinical spectrum of fibular hemimelia and discuss management issues. Design: Retrospective Hospital based case series involving five cases of Paraxial Fibular Hemimelia. Setting: Surgical Ward, Department of Paediatric Surgery, Children's Hospital, P. I. M. S. Subjects: Five consecutive cases of Fibular Hemimelia studied in the Paediatric Surgery Department. Main Outcome Measures: Clinical extent of the limb deformity, functional disability, associated malformations. All the patients were males. Average age of patients at the time of presentation was 4.2 months. 80% [n=4] of the patients had unilateral limb deficiency, while one patient [Case#4] had bilateral limb deficiency. Most of the cases had associated skeletal abnormalities. The most common associated abnormality was absence of lateral rays of foot in the same limb. Conclusions: Management of these patients is a real challenge because of reluctance for any form of ablative surgery and poor facilities for artificial prosthesis. In older children, we advised conservative management with surgical shoes and splints