Mirror Foot: Surgical Approach for Esthetic and Functional Improvement
Mirror foot is a rare congenital anomaly on to the spectrum of complex foot polydactyly. It may occur in isolation or associated with other malformations or genetic syndromes. This is a subject little described in the literature, with few publications on its treatment. We herein report the case of a...
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Published in | Revista brasileira de ortopedia Vol. 59; no. 3; pp. e462 - e466 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Germany
Thieme Revinter Publicações Ltda
01.06.2024
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Online Access | Get full text |
ISSN | 0102-3616 1982-4378 |
DOI | 10.1055/s-0042-1742341 |
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Abstract | Mirror foot is a rare congenital anomaly on to the spectrum of complex foot polydactyly. It may occur in isolation or associated with other malformations or genetic syndromes. This is a subject little described in the literature, with few publications on its treatment. We herein report the case of a 4-year-old female patient who presented with a left foot with 8 fingers, without other associated deformities, whose complaints included the impossibility of wearing shoes and social stigma. Radiographically, eight metatarsi with their respective phalanges, five cuneiform bones, and absence of bone deformities in the hindfoot were verified. The surgical approach was chosen in order to promote functional and esthetic improvement, as well as a better adaptation to the use of closed shoes, according to the patient's and family's desire. A dorsal and plantar V incision was performed, with resection of three supranumerary rays, including three central metatarsi with their nine corresponding phalanges, two cuneiform bones, tendons and extra digital nerves, followed by suture of the intermetatarsal ligaments, preserving the fingers with normal appearance, decreasing the width of the foot, and maintaining proper support. The reduction was maintained through transmetatarsal fixation with Kirschner wires. The postoperative period went on with the use of a walking boot and zero load, without complications, with removal o the Kirschner wires and allowing load on the limb after twelve weeks. |
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AbstractList | Mirror foot is a rare congenital anomaly on to the spectrum of complex foot polydactyly. It may occur in isolation or associated with other malformations or genetic syndromes. This is a subject little described in the literature, with few publications on its treatment. We herein report the case of a 4-year-old female patient who presented with a left foot with 8 fingers, without other associated deformities, whose complaints included the impossibility of wearing shoes and social stigma. Radiographically, eight metatarsi with their respective phalanges, five cuneiform bones, and absence of bone deformities in the hindfoot were verified. The surgical approach was chosen in order to promote functional and esthetic improvement, as well as a better adaptation to the use of closed shoes, according to the patient's and family's desire. A dorsal and plantar V incision was performed, with resection of three supranumerary rays, including three central metatarsi with their nine corresponding phalanges, two cuneiform bones, tendons and extra digital nerves, followed by suture of the intermetatarsal ligaments, preserving the fingers with normal appearance, decreasing the width of the foot, and maintaining proper support. The reduction was maintained through transmetatarsal fixation with Kirschner wires. The postoperative period went on with the use of a walking boot and zero load, without complications, with removal o the Kirschner wires and allowing load on the limb after twelve weeks.Mirror foot is a rare congenital anomaly on to the spectrum of complex foot polydactyly. It may occur in isolation or associated with other malformations or genetic syndromes. This is a subject little described in the literature, with few publications on its treatment. We herein report the case of a 4-year-old female patient who presented with a left foot with 8 fingers, without other associated deformities, whose complaints included the impossibility of wearing shoes and social stigma. Radiographically, eight metatarsi with their respective phalanges, five cuneiform bones, and absence of bone deformities in the hindfoot were verified. The surgical approach was chosen in order to promote functional and esthetic improvement, as well as a better adaptation to the use of closed shoes, according to the patient's and family's desire. A dorsal and plantar V incision was performed, with resection of three supranumerary rays, including three central metatarsi with their nine corresponding phalanges, two cuneiform bones, tendons and extra digital nerves, followed by suture of the intermetatarsal ligaments, preserving the fingers with normal appearance, decreasing the width of the foot, and maintaining proper support. The reduction was maintained through transmetatarsal fixation with Kirschner wires. The postoperative period went on with the use of a walking boot and zero load, without complications, with removal o the Kirschner wires and allowing load on the limb after twelve weeks. Mirror foot is a rare congenital anomaly on to the spectrum of complex foot polydactyly. It may occur in isolation or associated with other malformations or genetic syndromes. This is a subject little described in the literature, with few publications on its treatment. We herein report the case of a 4-year-old female patient who presented with a left foot with 8 fingers, without other associated deformities, whose complaints included the impossibility of wearing shoes and social stigma. Radiographically, eight metatarsi with their respective phalanges, five cuneiform bones, and absence of bone deformities in the hindfoot were verified. The surgical approach was chosen in order to promote functional and esthetic improvement, as well as a better adaptation to the use of closed shoes, according to the patient's and family's desire. A dorsal and plantar V incision was performed, with resection of three supranumerary rays, including three central metatarsi with their nine corresponding phalanges, two cuneiform bones, tendons and extra digital nerves, followed by suture of the intermetatarsal ligaments, preserving the fingers with normal appearance, decreasing the width of the foot, and maintaining proper support. The reduction was maintained through transmetatarsal fixation with Kirschner wires. The postoperative period went on with the use of a walking boot and zero load, without complications, with removal o the Kirschner wires and allowing load on the limb after twelve weeks. |
Author | Martins, Jefferson Soares Guerra, Lucas Almeida Rodrigues, Gabriella de Figueiredo Lehnen, Igor Matsuy Pacheco Santana, Luiz Fernando Batista |
AuthorAffiliation | 3 Grupo de Pé e Tornozelo do Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil 2 Unidade do Sistema Músculoesquelético, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil 1 Departamento de Ortopedia e Traumatologia, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil |
AuthorAffiliation_xml | – name: 1 Departamento de Ortopedia e Traumatologia, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil – name: 3 Grupo de Pé e Tornozelo do Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil – name: 2 Unidade do Sistema Músculoesquelético, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil |
Author_xml | – sequence: 1 givenname: Lucas Almeida orcidid: 0000-0002-8264-2829 surname: Guerra fullname: Guerra, Lucas Almeida organization: Departamento de Ortopedia e Traumatologia, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil – sequence: 2 givenname: Jefferson Soares surname: Martins fullname: Martins, Jefferson Soares organization: Grupo de Pé e Tornozelo do Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil – sequence: 3 givenname: Igor Matsuy Pacheco surname: Lehnen fullname: Lehnen, Igor Matsuy Pacheco organization: Departamento de Ortopedia e Traumatologia, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil – sequence: 4 givenname: Gabriella de Figueiredo surname: Rodrigues fullname: Rodrigues, Gabriella de Figueiredo organization: Departamento de Ortopedia e Traumatologia, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil – sequence: 5 givenname: Luiz Fernando Batista surname: Santana fullname: Santana, Luiz Fernando Batista organization: Departamento de Ortopedia e Traumatologia, Hospital das Clínicas da Universidade Federal de Goiás/Empresa Brasileira de Serviços Hospitalares (EBSERH), Goiânia, GO, Brasil |
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