PMC3148481_01
Phenotypic characterization revealed that the child exhibited the typical face associated with Larsen syndrome (a mid-face hypoplasia with a depressed nasal bridge), bilateral elbow, hip, and knee dislocations, and bilateral talipes equinovarus. The child's hips and knees could not be passively manipulated to normal position, and her elbows had fixed flexion contracture. There was a typical hyperextension deformity associated with her dislocated hips and clubfeet.
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There were typical hyperextension deformities associated with her dislocated hips and clubfeet (Figure 1).
(A, B, C) - A skeletal survey revealed that bilateral elbow and knee dislocations and a juxtacalcaneal accessory bone were present. The juxtacalcaneal bone aids in the diagnosis of Larsen syndrome.
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The latter finding aids in the diagnosis of Larsen syndrome (Figures 2 A, B, C).
Sagittal and coronal MRI imaging of the cervical spine showed no associated cervical kyphosis, although mild synchondroses of the vertebral bodies were noted.
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Sagittal and coronal MRI imaging of the cervical spine did not reveal associated cervical kyphosis, although mild synchondroses of the vertebral bodies were noted (Figures 3 A, B).
PMC3148481_02
Iliotibial band - insertion at tuberculum Gerdy and mobilization of the quadriceps.
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A release of the iliotibial band was performed by maintaining the insertion at the tuberculum Gerdy (Figure 4).
Shortening osteotomy.
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Hence, capsulorraphy, cruciate plasty and anterior stabilization by using Insall method were applied (Figure 5).
Orthotic management.
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Lastly, splints, physiotherapy, and orthotic management were successfully achieved (Figure 6).
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