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Fibular Hemimelia: Principles and Techniques of Management

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Pediatric Lower Limb Deformities

Abstract

Children with fibular hemimelia (FH) present with a short lower leg of varying degrees of severity, often accompanied by a wide range of associated anomalies of the ipsilateral foot, ankle, and knee. Mild cases need only appropriately timed contralateral epiphysiodesis. Moderate cases require tibial lengthening, with realignment of the ankle in selected cases. For severe cases, the choice comes down to amputation versus limb salvage. One of the biggest challenges in limb salvage is to obtain a plantigrade foot. For the stiff equinovalgus ankle (the most common severe manifestation of FH), special reconstruction techniques are recommended to achieve a plantigrade foot. The knee may require anterior or posterior cruciate ligament reconstruction. Knee valgus is often treated by growth modulation. Associated congenital femoral deficiency should be addressed, either with lengthening or with contralateral epiphysiodesis. In summary, treatment of FH must be individualized according to the needs and expectations of each family/child and the reconstructive options available regionally.

An erratum to this chapter can be found at DOI 10.1007/978-3-319-17097-8_33

An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-3-319-17097-8_33

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Authors and Affiliations

  1. International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Schoeneman Building, 2nd Floor, 2401W. Belvedere Ave, Baltimore, MD, 21215, USA

    John E. Herzenberg M.D., F.R.C.S.C. & Shawn C. Standard M.D.

  2. Department of Pediatric orthopedics, Tel Aviv Sourasky Medical Center, Dana Children’s Hospital, Tel Aviv, 64239, Israel

    Lior Shabtai M.D.

Authors
  1. John E. Herzenberg M.D., F.R.C.S.C.
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  2. Lior Shabtai M.D.
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  3. Shawn C. Standard M.D.
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Corresponding author

Correspondence to John E. Herzenberg M.D., F.R.C.S.C. .

Editor information

Editors and Affiliations

  1. Professor, Department of Orthopedics; Chief, Division of Pediatric Orthopedics, Rutgers-New Jersey Medical School, Newark, New Jersey, USA

    Sanjeev Sabharwal

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Herzenberg, J.E., Shabtai, L., Standard, S.C. (2016). Fibular Hemimelia: Principles and Techniques of Management. In: Sabharwal, S. (eds) Pediatric Lower Limb Deformities. Springer, Cham. https://doi.org/10.1007/978-3-319-17097-8_23

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  • DOI: https://doi.org/10.1007/978-3-319-17097-8_23

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17096-1

  • Online ISBN: 978-3-319-17097-8

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