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足趾发育不全作为儿童主要发育异常

Foot Oligodactyly as the Main Dysplasia in Children.

作者信息

Laliotis Nickolaos, Konstantinidis Panagiotis, Chrysanthou Chrysanthos

机构信息

Orthopaedics, Interbalkan Medical Center, Thessaloniki, GRC.

Anatomy and Surgical Anatomy, Aristotle University of Thessaloniki, Thessaloniki, GRC.

出版信息

Cureus. 2023 Feb 12;15(2):e34896. doi: 10.7759/cureus.34896. eCollection 2023 Feb.

Abstract

Introduction Foot oligodactyly is usually associated with fibular insufficiency or cleft foot syndrome. A foot with a reduced number of rays may occasionally have an isolated dysplasia. Methods We reviewed the clinical notes and X-rays of six children with oligodactyly, having a normal development of the tibia and fibula. Clinical evaluation recorded the plantigrade or deviated foot, appropriate shoe wear, and aesthetic presentation of barefoot children. Radiological examination revealed missing or hypoplastic bones in the foot, the presence of other deformities, and leg length discrepancy (LLD) of the affected limb. Results On clinical evaluation, all children except one had a plantigrade foot with normal shoe wear; the lesion was not spotted in three of them unless informed of the presence of the dysplasia. Radiological examination in four of them revealed the absence or hypoplasia of the navicular, with a normal shape of the first metatarsal. Calcaneocuboid joints were normal in five of them; LLD was the main problem in three children. The girl with bilateral oligodactyly presented as a normal child. Conclusion Oligodactyly may present as an isolated dysplasia. LLD in these patients, which is less severe than in children with fibular or tibial insufficiency, is the main issue that requires surgical management in later life. Prenatal diagnosis of oligodactyly as an isolated dysplasia is an important feature for appropriate counseling of parents.

摘要

引言

足部少趾畸形通常与腓骨发育不全或裂足综合征相关。足部射线数量减少的情况偶尔可能存在孤立性发育异常。

方法

我们回顾了6例少趾畸形儿童的临床记录和X线片,这些儿童的胫骨和腓骨发育正常。临床评估记录了患儿足的跖行或偏斜情况、合适的鞋类穿着以及光脚儿童的外观表现。放射学检查显示足部骨骼缺失或发育不全、是否存在其他畸形以及患侧肢体的腿长差异(LLD)。

结果

临床评估发现,除1例患儿外,其他所有患儿均为跖行足且鞋类穿着正常;其中3例患儿若未被告知存在发育异常,则未发现病变。4例患儿的放射学检查显示舟骨缺失或发育不全,第一跖骨形态正常。5例患儿的跟骰关节正常;3例患儿的主要问题是腿长差异。患有双侧少趾畸形的女孩表现正常。

结论

少趾畸形可能表现为孤立性发育异常。这些患者的腿长差异不如腓骨或胫骨发育不全患儿严重,是后期需要手术治疗的主要问题。产前诊断少趾畸形为孤立性发育异常是为家长提供恰当咨询的重要依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c849/10013307/cb581697903d/cureus-0015-00000034896-i01.jpg

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