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Pediatric longitudinal epiphyseal bracket: Review and case presentation.
1Foot and Ankle of West Georgia, 2751 Warm Springs Road, Suite A, Columbus, GA 31904, USA.
Summary
A rare longitudinal epiphyseal bracket in the great toe, often missed by X-rays, can be diagnosed with ultrasound. Surgical removal can improve growth, but long-term monitoring is crucial.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Developmental Biology
Background:
- Longitudinal epiphyseal bracket (LEB) is a rare congenital anomaly affecting bone growth.
- It occurs in 2-14% of congenital hand/foot deformities, with 11% in the great toe.
- Early diagnosis is challenging as radiographs may appear normal before ossification.
Observation:
- This case highlights a preossified LEB of the great toe.
- Diagnosis was achieved through clinical suspicion and ultrasound, despite initially unremarkable X-rays.
- Ultrasound effectively visualizes preossified LEB, confirming the diagnosis.
Findings:
- Surgical resection of the epiphyseal brackets led to progressive short-term improvement.
- The LEB deformity can cause significant growth aberrations in affected bones.
- Early diagnosis and intervention are key to managing LEB.
Implications:
- Ultrasound is a valuable tool for diagnosing preossified LEB when radiographs are inconclusive.
- Prompt surgical intervention can yield positive outcomes in managing LEB.
- Long-term skeletal monitoring is essential to ensure deformity resolution and guide further treatment if necessary.
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