The Association of Clubfoot and Fibular Hemimelia with Treatment Implications
EDWARD L. LESTER, M.D.
Congenital absence of the fibula is the most common absence or reduction of a long bone. it is associated with numerous other abnormalities of the lower extremity, such as PFFD, short curved tibiae, hindfoot bony abnormalities and severe vaIgus displacement of the foot and ankle associated with lateral ray deficiencies.
The consequences of the foot deformity and the shortening leads many patients to a course of treatment that requires prosthetic restoration. Thus, this group of patients makes up the largest single group of patients seen in children's prosthetics clinics relative to the lower extremity.
Papers on this subject generally emphasize foot position and treatment methods for that. Clubfoot, as a deformity associated with this condition, is only rarely mentioned and is never discussed relative to treatment. Both the vascular abnormalities that have been described and the hindfoot bony abnormalities would lead one to believe that treatment of the clubfoot in this condition might be inordinantly difficult.
A total of ten such cases were identified in the records of the Spokane Unit, Shriners Hospitals for Crippled Children, and are presented for a review of their course to date to provide an experience with this combination of conditions, since it has not otherwise been reported.
Shriners Hospital for Crippled Children, N820 Summit Blvd., Spokane, WA 99201-1598