Reconstruction of Mirror Foot with Dysplastic Tibia

The Mirror foot is a rare congenital anomaly associated with duplication of the structures of the foot. Verghese et al have classified these feet into three types. Type three is associated with a Dysplastic tibia of which only 5 have been reported. Surgical management has been reported in only two of these five cases which are in the form of amputation.

We would like to present the reconstruction of a Mirror foot associated with a dysplastic tibia. Our case which is only the sixth reported case attempts to present a surgical reconstruction to a plantigrade foot. Reconstruction was attempted in this case since the child showed a good quadriceps function at the knee. Reconstruction consisted of excision of the preaxial polydactyly to achieve a more cosmetic appearance to the foot as well as improve the ability to wear foot wear. The dysplastic tibia was osteotomized to correct the varus deformity and achieve a plantigtade foot. This helped the child to ambulate more easily with a shoe raise and a brace to maintain the correction achieved. At a five year follow up the child was walking and running with a shoe raise for a 9 cm limb length discrepancy. There was however recurrence of the deformity due to fibular overgrowth. The child's parents refused further reconstruction and were satisfied with the present function and appearance of the child.

Reconstruction can therefore be attempted in these limbs associated with good quadriceps function.