Reconstruction of Mirror Foot with Dysplastic Tibia

Area of Science:

• Orthopedic surgery
• Congenital anomalies
• Pediatric orthopedics

Background:

• Mirror foot is a rare congenital anomaly involving foot structure duplication.
• Type 3 Mirror foot, associated with a dysplastic tibia, is exceptionally rare, with only five cases previously reported.
• Surgical management for Type 3 Mirror foot is limited, with only two prior cases documented, both involving amputation.

Observation:

• This report details the sixth case of a Type 3 Mirror foot with a dysplastic tibia.
• The patient presented with a congenital anomaly requiring surgical reconstruction to achieve a plantigrade foot.
• Successful reconstruction was pursued due to the child's good quadriceps function, indicating potential for ambulation.

Findings:

• Surgical reconstruction involved excising preaxial polydactyly for cosmetic improvement and footwear compatibility.
• Osteotomy of the dysplastic tibia corrected varus deformity, facilitating a plantigrade foot position.
• Post-operative management included a shoe raise and brace, enabling the child to ambulate more easily.
• At five-year follow-up, the child demonstrated walking and running ability despite a 9 cm limb length discrepancy.
• Recurrence of deformity occurred due to fibular overgrowth, though parents were satisfied with functional outcomes.

Implications:

• Surgical reconstruction of Type 3 Mirror feet is a viable option in cases with adequate quadriceps function.
• This approach can improve cosmetic appearance and functional ambulation in patients with complex congenital foot anomalies.
• Further research into long-term management of residual deformities, such as fibular overgrowth, may be warranted.