Congenital Ball-and Socket Anomaly of the Ankle

Bettin, D.; Karbowski, A.; Schwering, L.

doi:10.1097/01241398-199607000-00014

Cited by 12 publications

(8 citation statements)

References 7 publications

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“…The main pathology is tarsal coalition with a spherical shape of the ankle joint, but often combined with LLD, absence or fusion of foot rays, hypoplasia of the fibula or even femoral pathology [15–17]. In the series of 14 cases analyzed by Pistoia et al [16], ten presented lack of foot rays, which, in most cases, was defined as lateral deficiency.…”

Section: Discussionmentioning

confidence: 99%

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Intermediate ray deficiency—a new type of lower limb hypoplasia

et al. 2012

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ObjectiveDiagnosis of fibular hemimelia is based on the identification of absence or shortening of the fibula in relation to the tibia. Despite the existence of different classifications of this congenital deficiency, certain morphological forms defy proper classification. One such form is absence of foot rays with leg shortening in the presence of an entire fibula. In these cases, foot morphology suggests that central foot rays, not lateral ones, are affected by the deficiency; thus justifying the hypothesis concerning the existence of a separate type of hypoplasia, which may be named “intermediate ray deficiency” (IRD).Materials and methodsNine patients with IRD, with an average age of 9.4 years at diagnosis (2.9–15), were analyzed. Clinical and radiographic parameters of the leg and foot were recorded according to the Stanitski classification of fibular hemimelia. The position of the lateral and medial malleoli was assessed. Axial alignment was analyzed according to the Paley method.ResultsThe number of foot rays in eight cases was 4, while in one case, it was 3. Talocalcaneal synostosis was observed in seven cases. The shape of the ankle joint was spherical in six cases, horizontal in two cases and valgus in one case. The position of the lateral malleolus was slightly higher compared to normal. An average functional leg length discrepancy was 4.4 cm. The average percentage of fibular shortening was 9.5 %, tibial shortening 8.7 % and femoral shortening 3.3 %. In all of the cases, slight knee valgus was observed on the femoral level (average 3.3°) and tibial level (average 2.0°). As a result, criteria for IRD diagnosis were proposed.Conclusion“Intermediate ray deficiency” might be defined as a separate type of lower limb hypoplasia.

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Section: Discussionmentioning

confidence: 99%

“…Also disputable is the coexistence of a BSAJ with femur pathology. Bettin et al [17] presented congenital BSAJ combined with the femur-fibula-ulna syndrome (10/11). Three of their cases were with a normal length of the fibula, and one had foot ray deficiency, defined as lack of fourth ray (not fifth ray, as in the other six cases).…”

Section: Discussionmentioning

confidence: 99%

Intermediate ray deficiency—a new type of lower limb hypoplasia

et al. 2012

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“…Its need for treatment remains controversial. 1 Many previous reports have been in children and young adults and noted good function with few symptoms. However, with increasing interest and knowledge regarding this condition, various symptoms and secondary changes have gradually been reported.…”

Section: Discussionmentioning

confidence: 96%

“…4,7 Although most cases are congenital and asymptomatic, abnormal inversion and eversion can result in recurrent ankle sprain and osteoarthritis over long-term follow-up. 1,19 The exact incidence of hindfoot malalignment associated with the ball and socket ankle deformity remains unclear. Generally, previous literature has reported that a ball and socket ankle drifts toward valgus as a result of a shortened fibula, spherical shape of the tibial plafond, and tarsal coalitions.…”

Section: Introductionmentioning

confidence: 99%

Ankle Fusion Combined With Calcaneal Sliding Osteotomy for Severe Arthritic Ball and Socket Ankle Deformity

et al. 2016

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“…This mechanism has also been involved in patients with ankle instability in Larsen syndrome, poliomyelitis, and congenital insensitivity to pain [2,3]. This mechanism has also been involved in patients with ankle instability in Larsen syndrome, poliomyelitis, and congenital insensitivity to pain [2,3].…”

Section: Case Reportmentioning

confidence: 99%