Type IV Tibial Dysplasia

Tibial dysplasia is very rare. It is commonly classified into four types in the Jones classificationJones classification: Type I is the total absence of the tibia, in Type II the proximal tibia is present, in Type III the distal tibia only is present, and in Type IV there is a diastasis of the distal tibia and fibula with shortening of the tibia. The case illustrated describes the management of a Type IV case. The rarity of the condition is such that even in specialist centers experience is limited and often treatment has to be individualized for each case although there are some broad principles. The condition of the foot will often dictate management – severe foot deformities and polydactyly are frequent and some form of amputation may offer the best functional result. In Type IV tibial dysplasia, there may be a reasonable foot, and reconstruction is often an option in contrast to Types I and III where because of the absence of a knee, as well as foot abnormalities, amputation gives the best result. Type II may be reconstructible.