Congenital fibular deficiency

Reggie C. Hamdy, Asim M. Makhdom, Neil Saran, John Birch

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


Congenital fibular deficiency (CFD) is characterized by a wide spectrum of manifestations ranging from mild limb length inequality (LLI) to severe shortening, with foot and ankle deformities and associated anomalies. The etiology of CFD remains unclear. Treatment goals are to achieve normal weight bearing, a functional plantigrade foot, and equal limb length. The recent Birch classification system has been proposed to provide a treatment guide: the functionality of the foot, LLI, and associated anomalies should be taken into account for decision-making. Treatment options include orthosis or epiphysiodesis, Syme or Boyd amputation and prosthetic rehabilitation, limb lengthening procedures, and foot and ankle reconstruction. The outcome of amputation for severe forms of CFD has shown favorable results and fewer complications compared with those of limb lengthening. Nevertheless, advances in the limb lengthening techniques may change our approach to treating patients with CFD and might extend the indications for reconstructive procedures to the treatment of severe LLI and foot deformities.

Original languageEnglish (US)
Pages (from-to)246-255
Number of pages10
JournalJournal of the American Academy of Orthopaedic Surgeons
Issue number4
StatePublished - Apr 2014

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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