Tibial hemimelia is a rare congenital issue. It is usually characterized by the absence of the tibia or even its underdevelopment. As the tibia is one of the two bones in our lower leg, this issue sometimes results in a deformed or even a shortened lower leg. Also, this condition can be severe for some people. In some situations, this issue even results in several ankle, knee, or foot abnormalities.
Type 3 Tibial Hemimelia
Type 3 tibial hemimelia is a rare health condition seen in children. In this condition, the upper half of the tibia is usually absent. A knee joint and malleolus characterize it. However, there is no distal tibial plafond. There are four types of tibial hemimelia among them, type 3 is the least common. Though this type’s distal tibia is absent, the proximal tibia is formed correctly.
Anatomy
Our lower legs are made of two long bones. Those are the tibia and fibula. The tibia is larger among these two. It can offer support to most of your body weight. Hence, it is quite a vital part of your ankle and knee joint. It even helps in standing, walking, etc. So, in the tibial hemimelia condition, this significant bone is absent or underdeveloped. Thus, the child may face several kinds of deformities.
Description
Tibial hemimelia may vary in severity in some situations. For example, in some patients, this bone may be absent, while in others, it might be formed partially. So, the severity depends on how much of this bone is malformed in a person’s leg. Usually, kids with tibial hemimelia have. Moreover, tibial hemimelia even accompanies some other unwanted conditions, like hip issues, knee deformities, foot deformities, and more.
Types
Generally, tibial hemimelia can be classified as: Type 2 tibial hemimelia, 3A and 3B. When doctors know the correct types of tibial hemimelia, they can determine the seriousness of the condition and the correct way to treat it.
Type 3A
Among the two types of Types 3 tibial hemimelia, this is less severe. In this type, doctors see the partial absence of the tibia. This bone may be incomplete or even shortened. As some parts of the tibia are present, the leg can still work to some extent. In some situations, proper medical intervention and treatment can help children with this issue live relatively normal lives. Some may even undergo surgery or prosthetics.
Type 3B
This type is a more serious form of tibial hemimelia. In this condition, the tibia is absent, and the leg is much softer than usual. Also, the patient may face some other deformities of the foot and knee, making it really difficult for them to stand or walk. Thus, this type of tibial hemimelia is very severe and might need reconstructive surgery. Some other treatment procedures include amputation or limb-lengthening procedures. This type usually needs more complex and long-term treatment procedures.
Cause
In most of the cases, it is seen that doctors have no idea exactly why a baby is born with tibial hemimelia. However, this condition may be passed on hereditarily. This condition is generally associated with a syndrome that may affect several body parts. Some of those may be:
- Langer-Giedion syndrome
- Werner’s syndrome
- CHARGE( coloboma, heart defects, atresia chonae, growth retardation, genital abnormalities, ear deformities) syndrome.
Tests
Some tests are available that enable doctors to confirm the diagnosis of this congenital condition. Those are:
- MRI: Magnetic resonance imaging scan of the child to know more about their ankle and knee joints.
- X-rays: X-ray images of the kids’ dense structure, like bone, are done. This will help the doctor to estimate the actual difference in the length of a kid’s legs. X-rays can be done just after birth. Although many bones are found during infancy, professionals can easily find the shortenibia from those images.
- Genetic Testing: If a specific medical condition causes a baby’s tibial hemimelia, the doctors may request a thorough evaluation by a genetic specialist.
Treatment
The main goal of treatment for type 3 tibial hemimelia is to offer a pain-free procedure. Also, professionals try to make the leg as close as possible in length to a normal leg by the time the child is fully grown.
Tibial hemimelia treatment is teamwork. Talking about the team and experts, it has occupational and physical therapists, pediatricians, orthopedics, prosthetists, and also orthotists.
Also, the entire treatment plan sometimes depends on several important factors, such as:
- How well the ankle and knee joints work.
- How much part of the tibia is absent?
- The overall health of the baby.
- The difference in the length of the two legs.
- Your family’s preference for a specific treatment procedure.
Surgical Treatment
The surgical treatments sometimes include procedures like:
- Limb amputation: This procedure may not offer the best result for many babies. For example, if the baby has no functional ankle joint, this procedure may be challenging.
- Reconstruction and lengthening of the limb: limb lengthening is good for kids with less severe conditions of tibial hemimelia.
Nonsurgical Treatment
In very mild cases of type 3 tibial hemimelia, nonsurgical treatment plans can be useful. Those may include:
- Prosthetics: When a doctor sees a larger difference in leg lengths, an artificial device is fitted over the shorter one. This will allow the baby’s foot to be flat on the floor.
- Wearing a shoe lift: If the foot of the kid can lift a shoe, this procedure can help. This shoe lift can help by evening out a little difference in leg length.
Conclusion
Babies suffering from type 3 Tibial Hemimelia can face some serious challenges in their lives. The damage to a vital limb may cause several unwanted physical abnormalities. So, if you want to help your loved ones fight against this serious congenital condition and live a better life, you must consult expert medical professionals.
