Complete fibular hemimelia: a long-term review of four cases.

Fibular hemimelia is a partial or total aplasia of the fibula, and is usually associated with other anomalies of the tibia, femur and foot. It represents the most frequent congenital defect of the long bones and is the most common skeletal deformity in the lower limbs. A retrospective study was made of four patients (three males and one female) with total aplasia of the fibula. The average follow-up was 15 years. Three patients were treated by successive tibial lengthenings; in one case amputation was carried out using the Syme technique. Lengthening required numerous operations and led to many complications, whereas the amputated case involved a single surgical operation without complications. The results of our cases and those reported in the literature suggest early amputation as the treatment of choice of Type II fibular hemimelia.