Tibial hemimelia

Therapy

Since the clinical manifestations and the associated dysfunctions vary widely for tibial hemimelia, each child must be examined carefully and receive an individual treatment plan.

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

At approximately 1 year of age, i.e. within the course of normal child development, children with tibial hemimelia can generally be provided with an orthosis, which allows them to learn to walk at a normal age, unless they suffer from severe comorbidities with developmental delays.

During the growth years, treatment plans vary considerably depending on the severity of the defect:

In principle, reconstruction is possible and in many cases worthwhile with type 2 and 3. With type 1 (complete absence of the tibia), however, surgical correction is very difficult and usually does not yield the desired success. Nevertheless, very good functional results in the foot/knee area can be achieved through targeted surgical procedures in these cases as well.

Therapeutic decisions should be closely coordinated with the parents and have one thing in common: in the end, the young adult should attain as much independence as possible, and pain from degenerative sequelae should not impair their quality of life until later on in life.