International Orthopaedics

, Volume 27, Issue 6, pp 338–342 | Cite as

Congenital longitudinal deficiency of the tibia

  • D. A. SpiegelEmail author
  • R. T. Loder
  • R. C. Crandall
Original Article


We performed a clinical and radiographic review of 15 patients (19 limbs) with longitudinal deficiency of the tibia treated between 1981 and 2001. Ten limbs with Kalamchi type I deficiencies were managed by through-knee amputation. Five type II deficiencies were treated by foot ablation and tibiofibular synostosis, either at the same time or staged, but prosthetic problems may arise from varus alignment and prominence of the proximal fibula. Patients with type III deficiencies (four cases) were treated by foot ablation. Prosthetic problems relating to proximal or distal tibiofibular instability may necessitate additional surgical intervention.


Synostosis Tibial Metaphysis Varus Alignment Proximal Fibula Prosthetic Fitting 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Nous avons fait une révision clinique et radiographique de 15 malades (19 membres) présentant une déficience longitudinale du tibia traitée entre 1981 et 2001. Dix membres avec un déficit type Kalamchi type I ont été traités par une désarticulation du genou. Cinq type II ont été traités par ablation du pied et synostose tibiofibulaire, en un ou plusieurs temps, mais, dans ces cas des problèmes prothétiques peuvent survenir à cause d'un varus ou de la proéminence du péroné proximal. Les malades avec un type III (quatre cas) a été traité par l'ablation du pied. Les problèmes prothétiques en relation avec une instabilité tibiofibulaire proximale ou distale peuvent nécessiter une intervention chirurgicale supplémentaire.


  1. 1.
    Brown FW (1965) Construction of a knee joint in congenital total absence of the tibia (Paraxial tibial hemimelia). A preliminary report. J Bone Joint Surg [Am] 47:695–704Google Scholar
  2. 2.
    Brown FW, Pohnert WH (1972) Construction of a knee joint in meromelia tibia (Congenital absence of the tibia) A fifteen-year followup study. J Bone Joint Surg [Am] 54:1333Google Scholar
  3. 3.
    Carranza-Bencano A, Gonzalez-Rodriguez E (1999) Unilateral tibial hemimelia with leg length inequality and varus foot: External fixator treatment. Foot Ankle 20:392–396PubMedGoogle Scholar
  4. 4.
    Christini D, Levy EJ, Facanha FAM, Kumar SJ (1993) Fibular transfer for congenital absence of the tibia. J Pediatr Orthop 13:378–381PubMedGoogle Scholar
  5. 5.
    Davids JR, Meyer LC (1998) Proximal tibiofibular bifurcation synostosis for the management of longitudinal deficiency of the tibia. J Pediatr Orthop 18:110–117CrossRefPubMedGoogle Scholar
  6. 6.
    de Sanctis N, Razzano E, Scognamiglio R, et al (1990) Tibial agenesis: A new rationale in management of type II—Report of three cases with long term followup. J Pediatr Orthop 10:198–201PubMedGoogle Scholar
  7. 7.
    Epps CH Jr, Schneider PL (1989) Treatment of the hemimelias of the lower extremity. Long-term results. J Bone Joint Surg [Am] 71:273–277Google Scholar
  8. 8.
    Epps CH Jr, Tooms RE, Edholm CD, Kruger LM, et al (1991) Failure of centralization of the fibula for congenital longitudinal deficiency of the tibia. J Bone Joint Surg [Am] 73:858–867Google Scholar
  9. 9.
    Fernandez-Palazzi F, Bendahan J, Rivas S (1998) Congenital deficiency of the tibia: A report on 22 cases. J Pediatr Orthop 7B:298–302Google Scholar
  10. 10.
    Grissom LE, Harcke HT, Kumar SJ (1990) Sonography in the management of tibial hemimelia. Clin Orthop 251:266–270PubMedGoogle Scholar
  11. 11.
    Jayakumar SS, Eilert RE (1979) Fibular transfer for congenital absence of the tibia. Clin Orthop 139:97–101PubMedGoogle Scholar
  12. 12.
    Javid M, Shahcheraghi GH, Nooraie H (2000) Ilizarov lengthening in centralized fibula. J Pediatr Orthop 20:160–162CrossRefPubMedGoogle Scholar
  13. 13.
    Jones D, Barnes J, Lloyd-Roberts GC (1978) Congenital aplasia and dysplasia of the tibia with intact fibula. Classification and management. J Bone Joint Surg [Br] 60:31–39Google Scholar
  14. 14.
    Kalamchi A, Dawe RV (1985) Congenital deficiency of the tibia. J Bone Joint Surg [Br] 67:581–584Google Scholar
  15. 15.
    Kumar A, Kruger LM (1993) Fibular dimelia with deficiency of the tibia. J Pediatr Orthop 13:203–209PubMedGoogle Scholar
  16. 16.
    Loder RT, Herring JA (1987) Fibular transfer for congenital absence of the tibia: A reassessment. J Pediatr Orthop 7:8–13PubMedGoogle Scholar
  17. 17.
    Ogden JA (1976) Ipsilateral femoral bifurcation and tibial hemimelia. A case report. J Bone Joint Surg [Am] 58:712–713Google Scholar
  18. 18.
    Pattison RC, Fixsen JA (1992) Management and outcome in tibial dysplasia. J Bone Joint Surg [Br] 74:893–894Google Scholar
  19. 19.
    Schoenecker PL, Capelli AM, Millar EA, Sheen MR, et al (1989) Congenital longitudinal deficiency of the tibia. J Bone Joint Surg [Am] 71:278–287Google Scholar
  20. 20.
    Simmons ED, Ginsburg GM, Hall JE (1996) Brown's procedure for congenital absence of the tibia revisited. J Pediatr Orthop 16:85–89CrossRefPubMedGoogle Scholar
  21. 21.
    Sulamaa M, Ryoppy S (1964) Congenital absence of the tibia. Acta Orthop Scand 34:337–348Google Scholar
  22. 22.
    Wehbe MA, Weinstein SL, Ponseti IV (1981) Tibial agenesis. J Pediatr Orthop 1:395–399PubMedGoogle Scholar
  23. 23.
    Wolfgang GL (1984) Complex congenital anomalies of the lower extremities: Femoral bifurcation, tibial hemimelia, and diastasis of the ankle. Case report and review of the literature. J Bone Joint Surg [Am] 66:453–458Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Shriners Hospitals for Children/Twin CitiesMinneapolisUSA

Personalised recommendations