Congenital Diastasis of the Inferior Tibiofibular Joint With Clubfoot and Imperforate Anus

Congenital diastasis of the inferior tibiofibular joint is a rare condition of unknown etiology, first described in 1972. Although its clinical presentation at birth is a talipes equinovarus deformity of the foot, it may be associated with limb length discrepancy and other skeletal and visceral abno...

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Bibliographic Details
Published in:The Journal of foot and ankle surgery 2007-03, Vol.46 (2), p.109-115
Main Authors: Dhammi, Ish K., MS, Talwar, Jatin, MS, Maheshwari, Aditya V., MS
Format: Article
Language:English
Subjects:
Abnormalities, Multiple - surgery
Ankle Joint - abnormalities
Anus, Imperforate - surgery
Biological and medical sciences
clubfoot
Clubfoot - surgery
congenital inferior tibiofibular diastasis
Diseases of the osteoarticular system
Fibula - abnormalities
Humans
imperforate anus
Infant
Male
Malformations and congenital and or hereditary diseases involving bones. Joint deformations
Medical sciences
Orthopedic surgery
Orthopedics
Osteoarthritis
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
talipes equinovarus
Tibia - abnormalities
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Summary:Congenital diastasis of the inferior tibiofibular joint is a rare condition of unknown etiology, first described in 1972. Although its clinical presentation at birth is a talipes equinovarus deformity of the foot, it may be associated with limb length discrepancy and other skeletal and visceral abnormalities. We present one such case of congenital inferior tibiofibular diastasis of Onimus type A variety (vertical diastasis) with talipes equinovarus, high imperforate anus, short first ray of the foot, intact superior tibiofibular joint, and no limb length discrepancy. Closed manipulation and casting had been unsuccessful, and at this time, the patient had not pursued any treatment during the past one year. A colostomy for the imperforate anus had been performed 36 hours after his birth and was planned for subsequent posterior sagittal anorectalplasty to reestablish continuity. His ankle joint was reconstructed along with soft tissue release for talipes equinovarus. Two years after surgery, he has a plantigrade stable foot with no limb length discrepancy. We propose that if the reconstructed joint is carried out in early childhood, it will provide better reciprocal joint surfaces with less chances of degenerative arthritis in later life. However, leg length inequality and recurrence of the deformities are not uncommon, necessitating further surgical interventions.
ISSN:1067-2516
1542-2224
DOI:10.1053/j.jfas.2007.01.003