Combined Fibular and Tarsal Agenesis in a Case of Lower Extremity Hemimelia

Fibular hemimelia is a congenital disorder characterized by partial or total absence of the fibula. The appearance of the affected limb can range from barely detectable to severe deformity. An affected extremity typically displays a valgus foot and ankle, shortening of the leg, anterior bowing of the tibia and knee, tarsal coalition, as well as radiographic absence of 1 to several lateral rays (1 and 2). We encountered an adult patient who displayed fibular agenesis in combination with absence of the ipsilateral talus and cuboid. Because of the rarity of this deformity, we believed that it was important to describe her case despite the fact that, after evaluation and discussion of treatment options, the decision was made to continue to accommodate the deformity with an orthosis.