Genu Recurvatum After Prolonged Bracing for Drop-Foot in a Patient With History of Guillain-Barre Syndrome

Abstract

A case of unilateral genu recurvatum (GR) in a 15-year-old boy with a history of Guillain-Barre syndrome (GBS) and subsequent bilateral drop-foot is presented. Muscle imbalance of the lower limb and repetitive pressure from prolonged usage of an orthosis to deal with drop-foot may be the causative factors for early partial physeal arrest of his right proximal tibia. The result was a right GR and a shorter right lower limb. A below the tibial tuberosity anterior opening-wedge oblique proximal tibial osteotomy was performed. The deformity was gradually corrected using an Ilizarof circular frame. The center of rotation and angulation of the procedure was placed at the posterior tibial cortex. The procedure was completed uneventfully within four months. Excellent clinical and radiological improvement of the deformity was obtained.

Single-Stage Correction of Genu Valgum Recurvatum by Distal Femoral and High Tibial Opening Wedge Osteotomies

“…Instead, we think the recurvatum deformity was likely a sequela of the patient’s left-sided hemiparesis. Asymmetric knee joint loading may induce pathologic wear patterns and, in skeletally immature individuals, threaten the physis and instigate premature closure 2,22 . The unilaterality of the deformity and localization to the favored side for weight-bearing suggest such a sequence as the most likely explanation for the development of genu recurvatum.…”