Congenital fibula aplasia

　　It may be due to developmental defects in the embryo. According to Bardenheuer, in the early stage of embryonic development, 1 main line and 4 nutritive lines occur. The femur, fibula, 2 tarsal bones, and the fifth toe arise from the main line, while the tibia and other foot bones arise from the lateral line. It is said that congenital tibial aplasia is caused by incomplete development of the first lateral line. Generally, most people agree with the theory of internal factors. Joachimstahl argues that it is caused by amniotic sac compression during the fetal period.

　　1. Foot drop is one of the signs of orthopedic surgery. The patient sits with the two lower limbs naturally hanging down, and if the foot is in plantar flexion and cannot actively extend and invert, it is considered foot drop.

　　2. Foot varus, also known as valgus foot, refers to the outward deviation of the foot axis of children, which is one of the common foot deformities. Foot varus is a deformity caused by abnormal development of the foot tendons.

　　3. Spina bifida (spinal bifida) also known as incomplete closure of the vertebral canal, a common congenital malformation. It is caused by incomplete closure of the vertebral canal during embryonic development.

Limp, shortening of the lower leg. There is a bow-shaped deformity of the tibia, and the foot is outwardly flipped and the external malleolus disappears, accompanied by other limb shortening deformities.
1. Type I
Unilateral partial absence, the lower leg can be moderately shortened, and there is generally no disability.
2. Type II
The fibula is almost completely absent, and the limb is very short. The tibia is completely arched at the middle and lower third. The skin has a slight concavity, but is not adherent to the tip of the arch; foot drop and outward翻；the ipsilateral femur is also shortened. Even with treatment, the function is poor.
3. Type III
It may be unilateral, or bilateral with other serious abnormalities such as upper limb or femur malformation, as well as spina bifida, etc. This kind of case is more common, and the prognosis is also poor.

　　This disease belongs to congenital malformation, and the preventive methods are as follows:

　　1. Measures to prevent fetal malformation; avoid fever and cold during the early stages of pregnancy. Women with high fever during the early stages of pregnancy may have adverse effects on the development of brain tissue, even if there are no obvious external malformations, but there may be intellectual impairment, poor learning and response ability. This intellectual impairment is irreversible. Of course, fetal malformation caused by high fever is also related to the sensitivity of pregnant women to high fever and other factors.

　　2. Measures to prevent fetal malformation; avoid contact with cats and dogs. Few people know that cats carrying bacteria are also a significant source of infectious diseases that can cause fetal malformation, and cat feces are the main route of transmission for this malignant infectious disease.

　　3. Measures to prevent fetal malformation; avoid women who wear heavy makeup every day. Surveys show that the incidence of fetal malformation in women who wear heavy makeup every day is 1.25 times higher than that of those who do not. The main adverse effects on the development of fetal malformation are toxic substances such as arsenic, lead, and mercury contained in cosmetics, which affect the normal development of the fetus. The second is that some ingredients in cosmetics produce aromatic amines with teratogenic effects after being irradiated by ultraviolet light from the sun.

　　4. Measures to prevent fetal malformation; avoid emotional tension during pregnancy. Human emotions are controlled by the central nervous system and the endocrine system, and one of the endocrine hormones, adrenal cortical hormone, is closely related to human emotional changes. When pregnant women are emotionally tense, adrenal cortical hormone may hinder the integration of certain embryonic tissues, and if it occurs during the first three months of pregnancy, it may cause fetal cleft lip or cleft palate and other malformations.

　　5. Measures to prevent fetal malformation; avoid drinking alcohol. Alcohol can pass through the placenta to the developing embryo, causing serious harm to the fetus. This may include a small head, extremely small ears and nose, and a thick upper lip.

　　6. Measures to prevent fetal malformation; avoid eating moldy foods. Experts have pointed out that if pregnant women consume food contaminated with mycotoxins (moldy food), mycotoxins can pass through the placenta to harm the fetus, causing chromosome breakage in fetal cells.

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　　Patients with congenital fibula absence may have a limp and shortening of the lower leg. There may be a bow-shaped deformity of the tibia, disappearance of the external malleolus of the foot, and associated other limb shortening deformities. In the diagnosis, in addition to relying on clinical manifestations, auxiliary examinations are also needed. X-ray examination can show the absence of the fibula.

　　Dietary recommendations for patients with congenital fibula absence: prefer light and nutritious food, eat more vegetables and fruits, and reasonably match the diet. Eat less fatty meat, high animal fat, and high cholesterol foods, as these can produce ketone bodies, acids, arachidonic acid metabolites, and inflammatory mediators, which can inhibit the function of T lymphocytes and easily cause and worsen joint pain, swelling, bone decalcification, and joint destruction.

　　Determined by the patient's age at the time of visit, degree of deformity, soft tissue tension, and classification. For children with Type I, if their limb shortening is less than 1.5 cm, they can compensate by raising the insole of the shoe. Children with Type II and III often have instability of the ankle joint, and the affected foot may develop an outward deformity.

　　Treatment methods include:

　　1. Use a frame to maintain the normal position of the foot and tibia.

　　2. Perform an osteotomy at the lower end of the tibia to maintain the normal horizontal position of the joint between the talus and tibia.

　　3. Fuse the talus with the tibia.

　　4. For those with partial absence of the fibula, perform a fibular lengthening surgery to restore the full length of the fibula.