Birch et al developed a functional classification for fibular deficiency. This can help guide decision making in patient management.
Parameters:
(1) functional foot
(2) limb length inequality (discrepancy)
(3) functional upper extremity
The presence or absence of a functional foot is the primary distinction between Types I and II.
Foot |
Limb Length |
Upper Extremity |
Type |
functional |
0 – 5% |
NA |
IA |
functional |
6 – 10% |
NA |
IB |
functional |
11 – 30% |
NA |
IC |
functional |
> 30% |
NA |
ID |
nonfunctional |
NA |
functional |
IIA |
nonfunctional |
NA |
nonfunctional |
IIB |
Type |
Management Recommendation |
IA |
orthosis or epiphysiodesis |
IB |
epiphysiodesis with/without lengthening |
IC |
1 or 2 lengthenings vs amputation |
ID |
3 or more lengthenings vs amputation |
IIA |
early amputation |
IIB |
consider salvage |
Specialty: Surgery, orthopedic, Genetics, Pedatrics
ICD-10: ,