Total ankle replacement for treatment of complex congenital fibular hemimelia

Abstract

Fibular hemimelia is a rare congenital disorder of unknown etiology characterized by fibular hypoplasia, dysplasia, or complete aplasia. The pathologic process is occasionally associated with other femoral, tibial and/or foot deformities. As these deformities can alter the mechanical axis of the lower extremity, abnormal joint mechanics predisposes those with fibular hemimelia to degenerative joint disease of the ankle joints, knee, and hip. Many reports have demonstrated surgical correction for complex tibial and fibular deformity in patients with fibular hemimelia; however, there is a general lack of documentation for surgical correction of ankle-driven deformity and pathology in patients with this congenital disorder. We present a case of Type 1A fibular hemimelia treated with total ankle replacement, with successful results recorded with over 12 years of follow-up.