What is it?

Children who have fibular hemimelia are born with a short or missing fibula (one of the two bones in the lower leg). Other bones in the leg, ankle, and foot can be affected too.
Most children with fibular hemimelia have it in one leg, but some have it in both. Experts who treat bone problems have several options to help kids with a hemimelia.

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Signs & symptoms

Symptoms that parents might see when a baby is born with hemimelia:
* When all or some of the bone is missing in one leg, the leg is shorter than the other. Doctors call this a leg length discrepancy.
* Because the shinbone is short or missing, the ankle joint may not form as it should. The ankle and foot might look different from normal.
* The child's knee and lower leg might bend inward.
* The child's lower leg may bow out.
* The foot may not have all five toes.
A baby with hemimelia can have problems that parents won't see. Doctors can find these through physical exams and tests:
* The hip joint may be too shallow.
* Some of the ligaments (strong, flexible bands of tissue) that hold the knee together may be weak or missing.


Often, doctors know that a fibula is short or missing before a baby is born. That's because prenatal ultrasound scans show the baby's bones as they form and grow.
If a mom didn't get a scan while pregnant, doctors will see the fibular hemimelia when the baby is born. They may order these tests to learn more:
* X-rays will show what the bones and joints look like.
* MRIs will let doctors see ligaments and other soft tissue in the foot and joints.


Treatment depends on how the child is affected. Some children with fibular hemimelia have very mild limb length difference and need very little treatment. Others have a large limb length difference and unstable joints.
When a child has fibular hemimelia, the leg may not grow as fast or as long as it should. Kids might have trouble standing or walking. Getting the right treatment is important.
Different experts work as a team to treat fibular hemimelia. The team is led by orthopedic specialists (doctors and other health care providers who treat bone and muscle problems). They work with other specialists as needed. Your child's team also might include physical therapists and an orthotist .
The care team will come up with a plan to help your child stand, walk, and play like other kids. The plan is based on:
* how much bone is missing
* how much difference there is in the length of the legs
* how the problem might affect your child as he or she grows
* whether your child has foot or ankle problems
You might need to bring your child for a series of visits over several months before the care team decides on treatment. This gives the team time to understand how your child will grow and what the difference in leg length might be.
When there isn't a lot of difference in leg length, a child might wear a special shoe or shoe insert. But most kids need surgery.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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