- Discussion:
- unlike
anterolateral bowing, this disorder is not assoc w/ other anomalies (like
neurofibromatosis) nor is it associated w/ tibial frxs or pseudarthrosis,
such as
congenital pseudarthrosis of tibia;
- clinical findings:
- posteromedial bowing
-
calcaneal valgus
- limb-length inequality;
- triceps surae weakness;
- Limb Shortening: (see:
limb growth deformities)
- limb is shortened 1 -1.5 cm at birth;
- some will have limb length discrepancies avg 4.0 cm at maturity;
- growth inhibition usually remains as a constant percentage over time, thus allowing future equalization procedures can be planned.
-
treatment options:
- casting:
- contralateral
epiphysiodesis;
- ipsilateral
limb lengthening;
- Bowing:
- angular deformity corrects spontaneously, but medial bowing may persist.
- occasionally, osteotomy is necessary to correct medial bowing.
- no orthotics are necessary and the patient should be observed.
- Calcaneal Valgus:
- calcaneal valgus foot position resolves gradually;
Posteromedial bowing of the tibia progression and discrepancy in leg lengths. Hofman A, Wenger DR: J Bone Joint Surg 1981;63A:384.
Congenital posteromedial bowing of the tibia and fibula. Pappas AN: J Pediatr Orthop 1984;4:525.
