Fibula dimelia in association with ipsilateral proximal focal femoral deficiency, tibial deficiency, and polydactyly. A case report.
A 16-year-old girl with bilateral tibial deficiency, left fibula dimelia, left proximal focal femoral deficiency, polydactyly, and congenital heart disease is now ambulatory and able to attend public school. This combination of anomalies has been overcome by cardiac surgery followed by Boyd-type amputation, prosthetic restoration, and therapy. The shortened left distal femur was lengthened by implanting both amputation fibulae proximally. In the same surgery, the amputation os calcis was fused distally to these fibulae. The right fibula was disarticulated at the knee. The female patient was fitted with bilateral knee disarticulation prostheses. She became fully ambulatory with a walker, progressing to bilateral forearm crutches. Recurrent deformity at the fusion site of the left femoral segment to the fibulae required a subsequent wedge osteotomy and multiple surgeries during the years following. Today she remains ambulatory with the use of nonaxillary crutches, attends public school, and is without pain. She takes part in athletics within the range of her abilities and hopes to obtain a driver's license and use a modified car. She is independent and well adjusted. Her progress has been followed from the age of 11-and-one-half months to present.
Shriners' Hospital for Crippled Children, Springfield Unit, Massachusetts.
R A
RA
Igou
L M
LM
Kruger
D000015:Abnormalities, Multiple / Q000534:rehabilitation; D000293:Adolescent; D000671:Amputation, Surgical; D001186:Artificial Limbs / Q000534:rehabilitation; D004188:Disarticulation; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000601:surgery; D005360:Fibula / Q000002:abnormalities*; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D007223:Infant; D013977:Tibia / Q000002:abnormalities* / Q000601:surgery; D014034:Toes / Q000002:abnormalities