Successful ambulation by surgical conversion in a complex form of epigastric heteropagus

Abstract

A female neonate with a complex form of epigastric heteropagus and with three legs was referred to us. The left leg appeared normal, the central one was hypoplastic and resected 1 month after birth, and the right one projected in the cranial direction with knee flexion contracture. Three bones of the parasite were sandwiched between the right ilium and the ischiopubic bones of the autosite. At the age of 4, we performed the subtrochanteric femoral osteotomy with 90 degrees of varization and rotation, along with knee disarticulation. Ambulation was successfully achieved with the prosthesis with a multiaxis knee unit.

Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review

“…Besides not being a primary study and not including a human participant, 268 abstracts were excluded during screening because they concerned arthroplasties, endoprostheses, surgical techniques/experiences/options, postoperative care/treatments/complications, upper limb prostheses, and flexion angles <25 or mild contractures. After full-text selection, 13 studies published between 1958 and 2017 were included for methodological quality assessment (Inter observer agreement ¼ 94%, kappa ¼ 0.88) [34][35][36][37][38][39][40][41][42][43][44][45][46], and 20 studies were excluded [9,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. Studies translated into English included three studies written in Russian [34,54,65], and 3 studies written in Dutch [51], Croatian [39], and Polish [56], respectively.…”