Fibular hemimelia

Fibular hemimelia or FH

Fibular hemimelia or longitudinal fibular deficiency is "the congenital absence of the fibula and it is the most common congenital absence of long bone of the extremities."[1] It is the shortening of the fibula at birth, or the complete lack thereof. In humans, the disorder can be noted by ultrasound in utero to prepare for amputation after birth or complex bone lengthening surgery. The amputation usually takes place at 6-months with removal of portions of the legs to retro fit them for prosthetic use. The other treatments which include repeated corrective osteotomies and leg-lengthening surgery are costly and associated with residual deformity.[2]

Bones of human lower extremity
  • Partial or total absence of fibula is among most frequent limb anomalies.[3]
  • It is most common long bone deficiency and is the most common skeletal deformity in the leg.[3]
  • It most often is unilateral (present only on one side).[3]
  • Paraxial fibular hemimelia is the most common manifestation (only the postaxial portion of the limb is affected).
  • It is commonly seen as complete terminal deficiency (lateral rays of the foot are affected as well).[3]
  • Hemimelia can also be intercalary in which case the foot remain unaffected.[3]
  • Although the missing bone is easily identified, this condition is not simply a missing bone.[3]
  • Males are affected twice as often as females in most series[3]
Laura was born with fibular hemimilia of her right leg. This caused her leg to be shorter and only part of her foot to develop. Vital bones never formed in her foot, ands so the doctors advised amputation. Laura was 4 years old.

Oct 2010

Oct 2011
What a big difference a year made right?! Yes. This IS the same child!!

Laura had a symes amputation (her foot was amputated at the ankle) to prepare her to wear a prosthetic leg. This was not a difficult decision due to the fact that Laura's foot was not a functioning foot. She had no ankle bones, and is missing her fibula. To amputate the foot so she could wear a prosthetic leg made sense to us.

These were taken January 5th 2010. The night before Laura's symes amputation. 

Our brave little girl

It was hard to send my princess into surgery. She had only been home with us for a few weeks. She didn't speak very much English. Laura's surgery was at Shriners Hospital in Phillidelphia, PA. The surgeon preformed a symes amputation and an osteotomy of her tibia to straighten it. The two procedures took over 4 hours.

Her tibia, which is the only bone in her lower leg was very curved in shape. She had an osteotomy (the tibia was severed and straightened with a rod). Laura was in a cast for about 6 weeks. At 6 weeks the rod was removed and her heel was allowed to heal more. At 7 weeks, the cast was removed and Laura was casted for her prosthetic leg.

I ordered a special doll for Laura to help explain to her what her leg would look like, what a prosthetic leg looked like etc.
Laura with her special doll, Faith

Laura had a series of X-rays to show how her tibia and heel were healing. The day the rod came out was not very pleasant for her. : (

Getting casted for her first prosthetic leg

Laura painted some pictures for the residents at the nursing home
Laura used this walker while in her cast and while waiting for her leg to be built. She still uses the walker now for taking showers and getting around when not wearing her leg (but she prefers the hopping method).

Here she is, just 10 weeks after surgery, trying on her leg and taking some first steps. The finished leg took 2 more weeks. Her stump was still pretty sore so the added time needed to make the leg was actually a good thing (although it didn't seem so at the time, I was so anxious to have her walking).

March 21, 2011

April 4, 2011

Her first unassisted steps!

Ta Da!

 April 4, 2011