A 32 month old female from a community in Niger Delta was seen at RAHI Hospitals Limited, Benin City on Thursday 11th January, 2018 with left lower limb deformity.

On critical examination of the patient, it revealed left lower limb shortening, absent tibia (Tibia hemimelia), dislocation of the knee, as well as unstable ankle ( club foot). The result from the X-ray of the lower limbs further gave credence to the above findings.

Tibia hemimelia is a rare congenital anomaly. The incidence is reported to be seen in one per million live births.

It could be unilateral or bilateral. It is associated with several syndromes such as Werner’s syndrome, triphalangeal thumb-polysyndactyly syndrome (TPTPS) e.t.c.

The gold standard for treatment is amputation with prosthetic fitting. The option of reconstructive surgery is limited and there is a high chance of dissatisfactory result; it involves reconstructing the knee, ankle joint and intermittent limb lengthening.

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