TIBIALHEMIMELIA; DO WE NEED A MODIFICATION OF THE CURRENTLY USED CLASSIFICATION SYSTEMS?

Background: Tibialhemimelia is a rare congenital anomaly,it may occur in isolated form or combined with other congenital anomalies.Differentclassification systemshad been used for classification. While inferior tibiofibular joint diastasis is a well-known accompanying deformity in subtypes of different classification systems; complete diastasis of tibia and fibula is not included in either of classification systems. Methods:Case 1: A 15 days infant presented to our unit with complete diastasis of tibia and fibula from the level of the knee joint. Each bone has its own skin envelop. Case 2:A four weeks old boy with a partial distal diastasis of tibia and fibula from the level of mid leg downward, with almost completely separate skin envelop for each part of the bone. A search in the English literature about reported cases with complete diastasis of tibia and fibula and different classification systems for tibialhemimelia was done. Result: No reported cases in the literature with complete diastasis of tibia and fibula. Conclusion: We suggest modification of the current classification systems for tibialhemimelia to include complete diastasis of tibia and fibula as a variant. Level of evidence: Level IV