Granite Guinevere, Herzenberg John E, Wade Ronald
Guinevere Granite, Department of Anatomy and Neurobiology, School of Medicine, University of Maryland, Baltimore, MD 21201, United States.
World J Clin Cases. 2016 Dec 16;4(12):401-408. doi: 10.12998/wjcc.v4.i12.401.
A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb's superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature.
一名7个月大的女性患儿,患有左胫骨半肢畸形(或先天性胫骨发育不全;Weber VIIb型,Jones等人1a型)、七趾型轴前多指畸形和重度马蹄内翻足(先天性马蹄足)。最终截肢手术在膝关节处离断了下肢。本病例报告描述了对下肢进行系统的截肢后检查的解剖学发现,包括浅部解剖、X线和计算机断层扫描(CT)。通过X线和CT扫描,我们发现轴前多指弯曲且重叠、第一跖骨发育不全、一个多指缺少中节和远节趾骨、三块跗骨、第四趾中节趾骨发育不全且无远节趾骨、第五趾无中节或远节趾骨。腓骨与跟骨前内侧相连,胫骨完全缺如。我们在浅部解剖中识别出了众多肌肉和神经,病例报告结果部分对此进行了描述。由于这种解剖学发现组合的罕见性,文献中对此类病例的描述非常少见。