近位けいひ関節癒合症の１例

Abstract

A case of proximal tibiofibular synostosis with a 1-year follow-up is presented. A 6-year-old female had no history of pain associated with activity in the left ankle and leg.Her mother noticed a prominence of the patient's fibula. Her developmental history was normal. There was no history of trauma or musculoskeletal infection.X-rays films showed a fusion of the proximal tibia and fibula. Physical examination revealed asymmetry of the legs. The left heel was in more valgus than the right, and the longitudinal arch of the left foot was lower than the right. The range of motion of the knees and ankles was symmetrical and normal.At 1-year follow-up, CT scanning showed a tight fusion. Photograph of the legs showed internal rotation of the patella, increased calf width, and planovalgus foot alignment on the left side as a result of congenital proximal tibiofibular synostosis. But she experienced no pain of the knees and ankles. We may apply custom-molded foot orthotics to elevate the arch of the foot and hold the heel in the neutral position, or choose operative treatment (excision) if the synostosis of the proximal tibiofibular joint results in further growth deformity of the leg, affecting the knee and foot alignment.