Peds

Question 0

Mainstay of treatment for types 2 and 4 tibial hemimelia?

Answer 0

Preserve leg length, establish plantigrade foot, stable knee with functional range of motion

Question 1

Mainstay of treatment for type 1 and 3 tibial hemimelia?

Answer 1

Early amputation and prosthetic rehabilitation

Question 2

What is the primary difference between type 1 and 2 tibial hemimelia?

Answer 2

In type 2 there is a remnant proximal tibia

Question 3

What’s the most common long bone deficiency?

Answer 3

Fibular hemimelia

Question 4

What is type 1 fibular hemimelia?

Answer 4

A) proximal and distal fibular epiphyses are more distal and proximal than normal, respectively

B) fibula is 30-50% shorter than normal

Question 5

What is type 2 fibular hemimelia?

Answer 5

Absence of fibula

Ankle can become ball and socket joint.

Question 6

What is treatment approach to fibular hemimelia?

Answer 6

If possible use leg lengthening. However if leg is too short and/or foot is very deformed, do amputation and prosthesis. Rule of thumb is if foot is more proximal than distal third of contra lateral tibia then can’t do lengthening.