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Lower Limb Abnormalities

Background

Common lower limb disorders, such as femoral torsion (abnormal twisting of the femur), tibial torsion (twisting of the bone between the knee and the ankle) which can cause intoeing (feet turning inwards), and foot disorders such as metatarsus adductus (curving of the foot) and flat feet, rarely need complex treatment. Observation and waiting to see how the child grows is often all that is required.

Leg Length discrepancy and Lower Limb Reduction defects
A difference in limb length can occur before or after birth and cover a wide spectrum of conditions which affect the bones in the leg, most commonly involving shortened and/or absent bones. These can range from the mild such as a slightly shortened femur or a missing toe, to severe such as a complete absence of the femur (thigh bone), no hip joint or an abnormal knee joint.

Conditions affecting the thighbone:

  • Congenital (present at birth) Short femur;
  • Proximal Focal Femoral Deficiency (PFFD).

Conditions affecting the lower leg:

  • Congenital short tibia (shin bone) with Fibular hemimelia (absent or hypoplastic (underdeveloped) calf bone);
  • Congenital Dysplasia (abnormal development) or absence of the tibia with intact fibula (Tibial hemimelia);
  • Congenital Tibia Recurvatum (bending backwards of the shin bone) or bowing of the back part of the tibia which frequently corrects itself.

These are called length defects and, in addition, there are a range of abnormal musculature and joints with missing ligaments associated with them. They include Congenital pseudarthrosis (false joint) of the tibia which is quite often associated with Neurofibromatosis.

Some limb reduction defects result in a failure of growth causing a complete absence of the limb beyond a certain level. Except for very minor conditions such as toe loss, these are defects requiring prosthetic (artificial) replacement and can sometimes be associated with amniotic band syndrome.

What are the symptoms? View What are the symptoms?

Medical text written June 2005 by steps. Approved July 2005 by Mr J A Fernandes, Consultant Paediatric Orthopaedic Surgeon, Sheffield Children's NHS Trust, Sheffield, UK.

 

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