Case 89: Arthrogryposis & Bilateral Clubfeet
A one week year-old boy presented with bilateral clubfeet and arthrogryposis. We treated his clubfeet with Ponseti casting, followed by bilateral tenotomy. Pateint began to develop equinus and varus deformities. We then performed bilateral Achilles tendon lengthening with posterior ankle release. In order to correct his developing adductus, we performed multiple osteotomy correction to align his feet, including cuneiform opening wedge osteotomies, cuboid closing wedge osteotomy, posterior ankle releases, and right-sided distal flexor hallucis release. Patient's feet are now well corrected and he can walk on his own two feet!
Case 90: Arthrogryposis & Ptergyium
A fourteen year-old boy from Italy presented with arthrogryposis and ptergyium. He had been wheelchair bound since age 6. We performed staggered two-stage correction of his lower extremities, including left knee posterior capsule release and medial nerve release, left foot osteotomies, and bilateral soft tissue releases of the feet, as well as a right posterior knee release (including hamstrings, gastrocnemius, fasciectomy, neurovascular bundle neurolysis, and posterior capsulotomy), patellar relocation with quadricepsplasty, and appliation of Ilizarov external fixator to the right foot. After treatment, we removed the external fixator and placed the patient in bilateral braces, which allowed the patient to walk unassisted for the first time in years! We also performed right elbow releases with radial head excision and ulnar nerve transposition to improve upper extremity function.
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