Granite G, Herzenberg JE, Wade R. Rare case of tibial hemimelia, preaxial polydactyly, and club foot. World J Clin Cases 2016; 4(12): 401-408 [PMID: 28035313 DOI: 10.12998/wjcc.v4.i12.401]
Corresponding Author of This Article
Guinevere Granite, PhD, Adjunct Professor, Department of Anatomy and Neurobiology, School of Medicine, University of Maryland, 655 West Baltimore Street, Baltimore, MD 21201, United States. guin.granite@gmail.com
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case-report
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Granite G, Herzenberg JE, Wade R. Rare case of tibial hemimelia, preaxial polydactyly, and club foot. World J Clin Cases 2016; 4(12): 401-408 [PMID: 28035313 DOI: 10.12998/wjcc.v4.i12.401]
World J Clin Cases. Dec 16, 2016; 4(12): 401-408 Published online Dec 16, 2016. doi: 10.12998/wjcc.v4.i12.401
Rare case of tibial hemimelia, preaxial polydactyly, and club foot
Guinevere Granite, John E Herzenberg, Ronald Wade
Guinevere Granite, Department of Anatomy and Neurobiology, School of Medicine, University of Maryland, Baltimore, MD 21201, United States
John E Herzenberg, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, United States
Ronald Wade, Department of Anatomical Services, University of Maryland, Baltimore, MD 21201, United States
Author contributions: Granite G acquired the specimen data, analyzed and interpreted the data, drafted the article, and made critical revisions related to important intellectual manuscript content; Herzenberg JE provided case material for analysis and made the final approval of the version of the article to be published; Wade R acquired the case material and specimen for article.
Institutional review board statement: The study did not need to be reviewed and approved by the University of Maryland, Baltimore Institutional Review Board because the case did not involve a living human being but a specimen from one that had been donated by the family for research purposes.
Informed consent statement: We have obtained the parent of the patients’ written informed consent for print and electronic publication of the report, as well as for reprinting in foreign editions of the journal.
Conflict-of-interest statement: The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoria; education grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. The authors declare that there is no conflict of interest regarding the publication of this article.
Correspondence to: Guinevere Granite, PhD, Adjunct Professor, Department of Anatomy and Neurobiology, School of Medicine, University of Maryland, 655 West Baltimore Street, Baltimore, MD 21201, United States. guin.granite@gmail.com
Telephone: +1-301-3957147 Fax: +1-410-7062512
Received: May 2, 2016 Peer-review started: May 6, 2016 First decision: July 25, 2016 Revised: August 5, 2016 Accepted: September 21, 2016 Article in press: September 22, 2016 Published online: December 16, 2016 Processing time: 219 Days and 6.8 Hours
Abstract
A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb’s superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature.
Core tip: This case report analyzes the anatomical findings associated with systematic post-surgical examination of the amputated lower leg of a seven-month old female presenting with a very rare combination of lower limb malformations. These include left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). This case report describes the results of the amputated limb’s superficial dissection, X-rays, and computed tomography scans. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature.
