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Tibial/Fibular Hemimelia
Arthur B. Meyers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Definitions

          • Melos: Greek root word for "limb"
          • Amelia: Complete absence of limb
          • Meromelia: Partial absence of limb
          • Hemimelia: Type of meromelia with absence of all or portion of distal limb
            • Transverse hemimelia: Defect of both tibia & fibula
            • Paraxial hemimelia: Defect of tibia (preaxial) or fibula (postaxial), not both
            • Terminal hemimelia: Associated absence of some or all of tarsals, metatarsals, & digits
            • Intercalary hemimelia: Hemimelia with no associated foot anomaly

        IMAGING

        • General Features

          • Radiographic Findings

            • Ultrasonographic Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • Staging, Grading, & Classification

                      • Gross Pathologic & Surgical Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Tsai A et al: Lower-extremity growth patterns and skeletal maturation in children with unilateral fibular hemimelia. Pediatr Radiol. 49(1):122-7, 2019
                                    2. Kaplan-List K et al: Systematic radiographic evaluation of tibial hemimelia with orthopedic implications. Pediatr Radiol. 47(4):473-83, 2017
                                    3. Paley D: Tibial hemimelia: new classification and reconstructive options. J Child Orthop. 10(6):529-55, 2016
                                    4. Bedoya MA et al: Common patterns of congenital lower extremity shortening: diagnosis, classification, and follow-up. Radiographics. 35(4):1191-207, 2015
                                    5. Huda S et al: Hemimelia and absence of the peroneal artery. J Perinatol. 34(2):156-8, 2014
                                    6. Radler C et al: Prenatal diagnosis of congenital femoral deficiency and fibular hemimelia. Prenat Diagn. 34(10):940-5, 2014
                                    7. Yoong P et al: Internal derangement of the knee in fibular hemimelia: radiographic and MRI findings. Knee. 21(3):749-56, 2014
                                    8. Oberc A et al: Fibular hemimelia - diagnostic management, principles, and results of treatment. J Pediatr Orthop B. 22(5):450-6, 2013
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Definitions

                                            • Melos: Greek root word for "limb"
                                            • Amelia: Complete absence of limb
                                            • Meromelia: Partial absence of limb
                                            • Hemimelia: Type of meromelia with absence of all or portion of distal limb
                                              • Transverse hemimelia: Defect of both tibia & fibula
                                              • Paraxial hemimelia: Defect of tibia (preaxial) or fibula (postaxial), not both
                                              • Terminal hemimelia: Associated absence of some or all of tarsals, metatarsals, & digits
                                              • Intercalary hemimelia: Hemimelia with no associated foot anomaly

                                          IMAGING

                                          • General Features

                                            • Radiographic Findings

                                              • Ultrasonographic Findings

                                                • MR Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • Staging, Grading, & Classification

                                                        • Gross Pathologic & Surgical Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Tsai A et al: Lower-extremity growth patterns and skeletal maturation in children with unilateral fibular hemimelia. Pediatr Radiol. 49(1):122-7, 2019
                                                                      2. Kaplan-List K et al: Systematic radiographic evaluation of tibial hemimelia with orthopedic implications. Pediatr Radiol. 47(4):473-83, 2017
                                                                      3. Paley D: Tibial hemimelia: new classification and reconstructive options. J Child Orthop. 10(6):529-55, 2016
                                                                      4. Bedoya MA et al: Common patterns of congenital lower extremity shortening: diagnosis, classification, and follow-up. Radiographics. 35(4):1191-207, 2015
                                                                      5. Huda S et al: Hemimelia and absence of the peroneal artery. J Perinatol. 34(2):156-8, 2014
                                                                      6. Radler C et al: Prenatal diagnosis of congenital femoral deficiency and fibular hemimelia. Prenat Diagn. 34(10):940-5, 2014
                                                                      7. Yoong P et al: Internal derangement of the knee in fibular hemimelia: radiographic and MRI findings. Knee. 21(3):749-56, 2014
                                                                      8. Oberc A et al: Fibular hemimelia - diagnostic management, principles, and results of treatment. J Pediatr Orthop B. 22(5):450-6, 2013