الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Fibular Hemimelia means partial or complete aplasia (deficiency) of the fibula. It is considered to be the commonest of all congenital longitudinal deficiency of the limb comprising an incidence ranging from 8 to 20 per million of all live births The etiology of FH is not exactly known, though it is most likely due to exposure to a certain teratogen in the 5th or 6th week of gestational life causing defective osteogenesis in the fibula and other associated bones that are marked together as the ’fibular developmental field’. The condition is associated with varying degrees of knee instability, genu valgum, tibial shortening, tibial anteromedial bowing, valgus unstable ankle, tarsal coalition and absent lateral rays of the foot. Several classification schemes exists for FH, the most famous of these is the Achterman and Kalamchi system (6), classifying the deformity into Type I: Partial (that is subdivided into IA, and IB according to whether the proximal fibula is intact or not) and Type II: Complete, where there is complete absence of the fibula. Recently, Paley et al (33) proposed a system for foot classification into: Type I: Horizontal Stable, Type II: Dynamic Valgus and Type III: Equinovalgus (the latter was subdivided into IIIa, IIIb, IIIc, and IIId according to the site of the valgus, being in the distal tibial articular surface, the subtalar joint or both) respectively. Management options of FH included limb reconstruction with foot reconstruction surgery, lengthening surgery or amputation and prosthetic fitting. Some studies advocate limb reconstruction, while others advocateamputation and the exact selection criteria for each are still not clearly determined.