Sahoo Pabitra Kumar, Sahu Mamata Manjari
Department of Physical Medicine and Rehabilitation, Swami Vivekanand National Institute of Rehabilitation Training and Research, Cuttack, Odisha, India.
Department of Physiotherapy, Swami Vivekanand National Institute of Rehabilitation Training and Research, Cuttack, Odisha, India.
J Orthop Case Rep. 2019;9(4):26-29. doi: 10.13107/jocr.2250-0685.1464.
Pre-axial foot polydactyly has been termed as mirror foot, otherwise known as diplopodia. Association of a hypoplastic trapezoid shaped tibia makes the condition extremely uncommon. Whatever limited literature is available, most of it is focused on the preliminary reconstruction of deformity which again may not be feasible in late presentation.
We present a 17-year-old girl having mirror foot with dysplastic trapezoid shaped tibia. She had mild equinovarus deformity of the right foot with three pre-axial extra digits that represent a mirror foot. There was also a gross shortening of the right leg with 20° fixed flexion deformity of the knee, but she could walk around with limited disability. Her chief complaint was difficulty in outdoor ambulation and poor cosmesis of the foot. Limb reconstruction may not have a predictable outcome with so much of shortening and she was also reluctant for amputation. A course of therapy was given with a treatment objective of improvement of knee flexion deformity and quadriceps control. She was fitted with an extension prosthesis which accommodates the deformed foot and also corrected the limb length discrepancy.
Mirror foot with dysplastic tibia reported at an adolescent age may not be benefitted from surgical reconstruction. Functional rehabilitation is better than an anatomic correction in case of late presentation.
轴前型足多指畸形被称为镜像足,也叫复足畸形。合并发育不全的梯形胫骨的情况极为罕见。现有的有限文献大多聚焦于畸形的初步重建,而这在晚期病例中可能并不可行。
我们报告一名17岁女孩,患有镜像足及发育异常的梯形胫骨。她右足有轻度马蹄内翻畸形,伴有三个轴前额外趾,构成镜像足。右腿明显短缩,膝关节有20°固定屈曲畸形,但她仍能有限度地行走,残疾程度较轻。她的主要诉求是户外行走困难以及足部外观不佳。鉴于有如此严重的短缩情况,肢体重建可能无法取得可预测的结果,而且她也不愿接受截肢。给予了一个疗程的治疗,目标是改善膝关节屈曲畸形并增强股四头肌控制能力。为她安装了一个可容纳畸形足并矫正肢体长度差异的延长假体。
青少年时期报告的伴有发育异常胫骨的镜像足可能无法从手术重建中获益。在晚期病例中,功能康复比解剖矫正更好。