Tibial Hemimelia

Therapy

Since the clinical picture and the associated functional deficits vary very widely for the tibial defect, each child must be examined carefully and must receive an individual treatment plan.

Since particularly the malposition of the foot responds well to treatment with a cast in the first months of life, the consultation with a centre for limb reconstruction should take place very early. Also an early introduction to physiotherapeutic treatment is very important, where the necessary exercises can soon be performed by the parents themselves.

At the age of approximately 1 year, meaning within the course of normal child development, usually every child with a tibial defect can be provided with an orthosis. Thus, it can learn to walk in time, unless it suffers from severe concomitant diseases with retarded development.

In the further process of growth, the treatment concepts vary considerably  , depending on the severity of the defect:

In principle, a reconstruction is possible and in many cases also worthwhile with type 2 and 3. However, with type 1, meaning a complete lack of a tibia, a surgical correction is very difficult and usually does not result in the desired success. Also here, however, targeted operative measures can achieve a very good functional result in the area of the foot and the knee.

Therapeutic decisions should be closely co-ordinated with the parents in each case and have one thing in common: In the end, the young adult should attain as much independence as possible, and pain by degenerative sequelae should only impair the quality of life at a higher age.