[Aplasia of the tibia - a case report with observation for 38 years (author's transl)].

The paper reports the result of operative treatment in a case of total congenital absence of the tibia. The boy was treated conservatively by plaster casts and apparative supports until he was six years old. Then the upper end of the fibula was set into the intercondylic fossa of the femur and two months later a talofibular fusion correcting the clubfoot deformity was performed. 32 years after this procedure the leg is now 28 cm shorter. The knee joint is absolutely stable in extended position and active flexion is possible to 45 degrees. The fibula shows a remarkable hypertrophy and has changed its form into a tibia-like bone. The patient is able to walk 15 km without any pain using a supporting apparatus. In congenital absence of the tibia or fibula we prefer orthopedic - surgical devices which preserve the dysplastic part of the limb instead of primary amputation.