UNCLASSIFIED CASES OF TIBIAL HEMIMELIA; SHOULD WE MODIFY THE CLASSIFICATION SYSTEMS?

Abstract

Tibial hemimelia is a rare congenital anomaly, may be in isolated form or combined with other congenital anomalies. Different classification systems had been used for classification. While inferior tibio-fibular joint diastasis is a well-known accompanying deformity in subtypes of different classification systems; complete diastasis of tibia and fibula is not included in either of classification systems. Case 1: A 15 days infant presented to our unit with complete diastasis of tibia and fibula from the level of the knee joint. Case 2: A four weeks old boy with a partial distal diastasis of tibia and fibula from the level of mid leg downward, with almost completely separate skin envelop for each part of the bone. A search in the English literature for reported cases with complete diastasis of tibia and fibula and different classification systems for tibial hemimelia was done. No reported cases in the literature with complete diastasis of tibia and fibula finally, we suggest modifying the current classification systems for tibial hemimelia to include complete diastasis of tibia and fibula as a variant.