Bartek Bułat was born with tibial hemimelia - a congenital lack of a tibia. Doctors initially suggested that the parents should amputate, but Dr. Dror Paley of The Paley Advanced Limb Lengthening Institute suggested surgery to reconstruct the child's legs.
Tibial hemimelia-congenital lack of tibiasuffering fromBartek Bułat , present very, very rarely - once in a million births, and only 30 percent of cases affect both limbs. Bartek's parents are trying to confirm the information that so far in Poland there has not been a case of bilateral congenital lack of tibia bones.
Tibial hemimelia: what is the disease?
Tibial hemimelia causes shortening of the limb / limbs with the foot / feet in extreme supination. If the knee joint is developed, it is unstable in 90 cases. The fibula is axially displaced from the femur, it can also be deformed or normal.
Bartek has a well-developed knee joint in his right leg and the remains of a tibia. There is no knee joint in the left leg but a developed kneecap which is very important for further treatment. There are no ankle joints in both legs.
Tibial hemimelia: treatment
Treatment of tibial hemimelia depends on the degree and type of the defect. It is very important to diagnose whether the knee joint and patella are present. In most of the described medical cases, and in the opinion of orthopedists, the best way for the patient to function independently is Syme's amputation (through or through the knee) and further prosthesis of the limb. Amputation is recommended after the age of 12 months. When the moment is right, the baby learns to walk on dentures right away.
Tibial hemimelia: Bartek's operation
Bartek Bułat will be treated by Dr. Dror Paley using the Ilizarov apparatus, who also plans to perform joint and muscle reconstruction. Bartek's operation will take place in three phases. In each phase, both legs will be operated on in one operation to reduce the time and number of hospital stays.
The first phase is to align the feet and fibula in the correct position and create the left knee joint. Both legs will probably stay for the next 4-6 months (including the second phase of surgery)placed in the Ilizarov apparatus. After the first phase of the operation, the child will be rehabilitated for 8 weeks.
The second phase of the operation is to connect the fibula with the tibia nucleus (which now protrudes from his right leg below the knee) into a single bone. In the left leg, the talus bone will be connected to the fibula. An ankle joint will be created in both feet. After the second phase, rehabilitation will last 4 weeks.
The third phase will take place after 2-3 months - the braces will be surgically removed and replaced with a plaster cast for a month. After its removal, the child will use orthoses and will be able to start learning to walk. If the baby's legs are not growing evenly, another surgery may be necessary.
More information about Bartek Bułat and hemimelia can be found at www.bartekbulat.pl