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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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The external iliac artery transitions out of the body cavity, entering the femoral region of the lower leg, and is renamed the femoral artery at the point where it traverses the body wall. This artery is responsible for the distribution of blood to the thigh's deep muscles and the skin's ventral and lateral regions, achieved through several minor branches and the lateral deep femoral artery, which also spawns a lateral circumflex artery. The knee area receives blood from the genicular...
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Surgical Angiogenesis in Porcine Tibial Allotransplantation: A New Large Animal Bone Vascularized Composite Allotransplantation Model
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Unclassified tibial hemimelia.

Vishnu Senthil1, Imthias V Kottamttavide1, Hitesh Shah1

  • 1Department of Orthopedics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

BMJ Case Reports
|June 10, 2016
PubMed
Summary

Tibial hemimelia is a rare congenital condition. This case presents an unclassified variant, potentially a type 2 tibial hemimelia with fused tibia and fibula.

Area of Science:

  • Orthopedics
  • Medical Genetics
  • Developmental Biology

Background:

  • Tibial hemimelia is a rare congenital longitudinal deficiency of the tibia, with an incidence of 1 in 1,000,000.
  • Existing classifications (e.g., Jones, Kalamachi) describe various forms of tibial hemimelia, often with specific fibular involvement.
  • Accurate classification is crucial for understanding prognosis and guiding treatment strategies.

Observation:

  • A 6-year-old girl presented with congenital shortening of the right lower limb.
  • Clinical examination revealed a small, rudimentary foot with all toes present and a hyperlax ankle.
  • Radiographic imaging demonstrated partial fusion (synostosis) of the tibia and fibula.

Findings:

  • The observed tibial hemimelia featured a partial tibia and fibula in synostosis.

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  • This presentation shares similarities with Jones and Kalamachi type 2 classifications but differs due to the abnormal fibula.
  • The case is proposed as a variant of type 2 tibial hemimelia, highlighting a previously unclassified presentation.

    • Implications:

    • This report expands the understanding of tibial hemimelia classification by presenting an unclassified variant.
    • Recognizing such variants is essential for accurate diagnosis and tailored orthopedic management.
    • Further research into the genetic and developmental underpinnings of these variations may improve patient outcomes.