ABSTRACT
The Tibial hemimelia is a less common deficiency of the lower extremity in comparison to fibular hemimelia or femoral deficiencies. The occurrence rate quoted in the United States is about one per million live births. The tibial deficiencies occur more frequently than fibular deficiencies in syndromic children. The deficiency may be bilateral and where part of a ‘syndromic’ presentation, other abnormalities may be readily apparent. It can occur both as an isolated deficiency and as an inherited condition. The hip in tibial hemimelia may be dislocated from birth. This is uncommon but does raise treatment difficulties as the usual orthoses such as the Pavlik harness may not be appropriate for treating the hip dislocation in the presence of an unstable knee and ankle in type I patients. It may be necessary to use a hip spica if a closed reduction is possible. If the hip is irreducible then an open reduction via a medial approach is advised for typical dislocations.
