Tibial Hemimelia Type 1A Jones anatomical dissection With Proposed Reconstructive Procedure for the Ankle.

Tibial hemimelia one of the limb deficiencies that has been under investigation for the best protocol of management. Especially type 1A Jones (1) with complete absence of the tibia had one of the less favorable outcomes. Reconstruction versus disarticulation still 2 different pathways of management. Understaffing the anatomy of the ankle in such deformity will enlighten the reconstruction of the ankle and foot. Material and Methods 4 patients presented with type 1A tibial hemimelia with lack of the extensor mechanism been treated with knee disarticulation. 3 were males and one female age range from 8 months to 19 months. The limbs were dissected to assess the anatomical variability of the muscle, joints, and neurovascular structure around the ankle. an osteotomy was done to correct the ankle deformity . The motion pre and post the suggested osteotomy was digitalized to ease the understanding of the procedure. Results There was no difference in the neuro-vascular (NV) structure rather than that the posterior NV structure is tight and stretched. The tibilais anterior and posterior as the same insertion in a single tendon on all specimens. Tarsal coalition between the talus and calcaneus in all legs. The medial surface of the fibula articulates with the superior surface of the talus. Add the supra-fibular osteotomy and rotating the foot 90 degrees with shortening of the fibula will correct the ankle in a single procedure. Conclusion The supra-fibular osteotomy can be an easy simple procedure to reconstruct the ankle in tibial hemimelia type 1A.