Prenatal ultrasonographic diagnosis of posteromedial bowing of the leg: two case reports

Zollinger, Paul E.; Wessels, Marja W.; Wladimiroff, J. W.; Diepstraten, A. F. M.

doi:10.1046/j.1469-0705.2000.00048.x

Cited by 14 publications

(10 citation statements)

References 12 publications

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“…Bowing was located more frequently in the distal than in the middle third, and posterior angulation was of a greater magnitude than medial bowing. Those findings are similar with other reports (1,2,5). Bowing of tibia is almost uniformly accompanied with calcaneovalgus of various degree (2,7,11).…”

Section: Figure 2 Progression Of Lld With Growth (Case 4) On Ap X-rsupporting

confidence: 93%

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Congenital Posteromedial Bowing of the Tibia: A Single Center Experience

Živanović¹,

Slavkovic²,

Marjanović³

et al. 2017

Acta Facultatis Medicae Naissensis

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SU M M A RY Congenital posteromedial bowing of the tibia (CPMBT) is a rare congenital anomaly of the lower limbs.The aim of the present study was to analyze our experience in the treatment of CPMBT.A retrospective study of patients treated for CPMBT in the period January 2000 -June 2016 was performed. In the observed period, six patients were treated (five girls and one boy), with predominance of the right tibia involvement (5:1).The initial treatment included a series of corrective casts (4-9) applied in all patients, followed by removable splints and physiotherapy. Four children with residual angulation of tibia after walking age were prescribed ankle-foot orthosis (AFO) as a prevention of pathological fractures. Both posterior and medial angulation correct over time. Mean initial shortening was 11 mm. At the last follow-up visit, mean shortening was 23.33mm. Three patients had lower limb shortening of more than 2 cm. In two of them, with shortening of 27 mm and 35 mm, Ilizarov lengthening was performed. In one girl, we performed lengthening over titanium elastic nails. In the other girl, after lengthening, circular frame was exchanged with a locking plate to reduce fixator wearing time. There were no major complications of treatment. Patients were followed up for 2-12 years (mean 6.83 years). None of them reached skeletal maturity yet.Primary manifestation of CPMBT -angulation of tibia and fibula as well as calcaneovalgus deformity usually correct spontaneously or with conservative measures. However, limb length inequality, as a consequence of CPMBT, progresses with growth and may require surgical correction in some children. Therefore, all children with CPMBT should be followed up until skeletal maturity.

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Section: Figure 2 Progression Of Lld With Growth (Case 4) On Ap X-rsupporting

confidence: 93%

“…Occasionally, it is diagnosed prenatally by ultrasound as early as at 20 weeks of gestation (1), but in most cases it is diagnosed at birth (2). Etiology and pathogenesis of the anomaly still remains unclear (3).…”

Section: Introductionmentioning

confidence: 99%

Congenital Posteromedial Bowing of the Tibia: A Single Center Experience

Živanović¹,

Slavkovic²,

Marjanović³

et al. 2017

Acta Facultatis Medicae Naissensis

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“…The angulation of the tibia and fibula is in the medial and posterior direction—with equal angle of bowing (varying from 25° to 70°) usually in the middle or distal third of the shaft [2]. The anomaly is unilateral, not associated with any other abnormality [3], accompanied by an initial calcaneovalgus deformity of the foot and decrease in ankle motion that does not improve with age.…”

Section: Introductionmentioning

confidence: 99%

“…The shortening increases with age [2, 6] to a length deficit of 4 – 7 cm at maturity [4] and is the most serious sequel. It may be serious enough (greater than 2 cm) to require limb length equalisation [7].…”

Section: Introductionmentioning

confidence: 99%

Limb lengthening in congenital posteromedial bow of the tibia

Kaufman¹,

Fagg²,

Jones³

et al. 2012

Strategies in Trauma and Limb Reconstruction

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Congenital posteromedial bowing of the tibia (PMBT) is a rare condition affecting one lower limb. The bowing of the tibia usually resolves; however, there is associated limb length discrepancy (LLD), which often persists and can cause functional deficits. Advances in limb lengthening techniques allow this issue to be addressed, often with concomitant angular deformity correction. This study examined eleven patients who have had limb lengthening procedures with mean pre-operative LLD of 3.7 cm (range 1.5–5 cm), mean increase in length was 3.9 cm (range 1.5–5.8 cm), and mean LLD at last follow-up was less than 0.6 cm (range 0–2.0 cm). The main complications were minor or moderate grades, such as pin site infection. Greater LLD was found than previously reported, and we believe that the tertiary referrals were those of a severe form of PMBT. The authors conclude that in view of deformity with discrepancy, in select cases, correction and lengthening would be an option rather than only contralateral epiphysiodesis.

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“…Few cases of prenatal detection have been reported [2]. If detected antenatally, the sonologist should record position, movement and shortening of affected limb and compare subsequently.…”

Section: Discussionmentioning

confidence: 99%

Congenital Unilateral Bowing of Tibia and Fibula

Rk¹

2008

Medical Journal Armed Forces India

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Prenatal ultrasonographic diagnosis of posteromedial bowing of the leg: two case reports

Cited by 14 publications

References 12 publications

Congenital Posteromedial Bowing of the Tibia: A Single Center Experience

Congenital Posteromedial Bowing of the Tibia: A Single Center Experience

Limb lengthening in congenital posteromedial bow of the tibia

Congenital Unilateral Bowing of Tibia and Fibula

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