Fibular Hemimelia: A New Classification System

A new classification system for fibular hemimelia is proposed based on the authors' experience with 32 patients with 33 involved limbs representing a spectrum of involvement. The data demonstrate the broad and unpredictable relationships among the fibula, ankle, and foot in this disorder. The classification system, based on fibular and ankle morphology, hindfoot coalition, and foot ray deficits, is designed to improve communication about the condition. Because of the variability and unpredictability of the multiple relationships, limb salvage criteria should also include the nature of the foot and ankle and not merely depend on the length discrepancy or the presence or absence of the fibula.