PMC7210900_01
Initial presentation as clubfoot deformity. Clinical picture with clubfoot and shortening of the limb.
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F1
Distal tibiofibular diastasis, initial X-ray, and computerized tomography (CT) scan. Congenital distal tibiofibular diastasis, with the talus intervening, with a CT reconstruction.
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F2
There was shortening of the tibia (Fig. 2).
Arthrodesis of distal tibiofibular diastasis, X-ray. X-ray after the performed arthrodesis, with the attempt to correct the deformity.
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F3
The metalwork was removed 3 years later and an attempt to correct the valgus position of the knee was done with a plate at the medial growth plate of the distal femur (Fig. 3).
X-ray AP both tibia and lateral X-ray of the affected limb, clinical picture, before surgical reconstruction. Radiological examination before the surgical reconstruction with the Ilizarov frame. Equinus and varus position of the foot. Limb length discrepancy.
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F4
A scanogram estimated the LLD at 6,5 cm for the tibia (Fig. 4).
Correction of equinus and varus position with the Ilizarov frame. Opening wedge osteotomy and correction of equinus and varus with gradual distraction, with the Ilizarov frame
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F5
We achieved a full correction of the position of the foot, using appropriate hinges, and new bone developed in the widening of the osteotomy (Fig. 5).
X-ray at the removal of the frame. Radiological examination with appropriate bone regenerates at the lengthening of the tibia.
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F6
The boy started walking with crutches with gradual weight-bearing, with the orthosis (Fig. 6).
Clinical picture at the end of treatment. Clinical picture at the end of correction, with a plantigrade foot.
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F7
His latest follow-up, 1 year after the frame removal, he is walking around using only the foot orthosis (Fig. 7 and 8).
Final X-ray of the limb, AP both tibia and lateral right tibia. X-ray with normal position of the foot, complete healing of both osteotomies.
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F8
His latest follow-up, 1 year after the frame removal, he is walking around using only the foot orthosis (Fig. 7 and 8).