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Sharat Agarwal*
 
Department of Orthopaedics and Trauma, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India, Email: drsharat88@yahoo.com
 
*Correspondence: Sharat Agarwal, Department of Orthopaedics and Trauma, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India, Email: drsharat88@yahoo.com

Received: 01-Nov-2022, Manuscript No. amhsr-22-82127; Editor assigned: 03-Nov-2022, Pre QC No. amhsr-22-82127 (PQ); Reviewed: 18-Nov-2022 QC No. amhsr-22-82127; Revised: 28-Nov-2022, Manuscript No. amhsr-22-82127 (R); Published: 05-Dec-2022

Citation: Agarwal S. Paley??s 3 Fibular Hemimelia in a 2-Month-Old Infant. Ann Med Health Sci Res. 2022;12:362-363.

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Case Description

Fibular Hemimelia (FH) is a congenital deficiency where part or all of the fibular bone is hypoplastic, dysplastic or aplastic associated with dysplasia of tibia and parts of the foot [1]. The Paley classification is the first classification of FH to be designed with reconstructive surgery options in mind. In type 3, there is a fixed deformity of equino-valgus. Here, we present a case who was 2 months old. On examination there was anteromedial bowing of tibia with absent fibula and lateral 2 toes and syndactyly of 2nd and 3rd toes. There was shortening of 2 cm, with projected shortening of tibia of 11 cm at maturity based on Paley’s multiplier method (Figures 1-4). Reconstructive surgery is planned in follow up as:

Figure 1: Clinical picture showing Fibular Hemimelia of right lower limb with bowing and shortening with classical dimple at the apex of the deformity.

Figure 2: Clinical picture showing absent lateral 2 toes with syndactyly of 2nd and 3rd toes.

Figure 3: Radiograph showing complete aplasia of fibula on the right side with normal hip and knee and absent lateral 2 toes.

Figure 4: Radiograph showing fibular aplasia on the right side with tibial bowing, shortening and equinovalgus ankle and foot.

• Surgery#1, at age 18 months, SUPER ankle (Systematic Utilitarian Procedure For Extremity Reconstruction) procedure combined with lengthening of 5.0 cm combined with hemiepiphysiodesis of distal femur for valgus knee correction.

• Surgery #2, at age 8 years, lengthening 6.0 cm of tibia.

References

  1. Paley D. Surgical reconstruction for fibular hemimelia. J Child Orthop. 2016;10:557-583.

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