Acquired Calcaneus Deformity Secondary to Osteomyelitis of the Distal Tibia

by MASS4D® Prescription Orthotics October 04, 2017

The purpose of this case report was to present an unusual complication of osteomyelitis of the distal metaphysis of the tibia in a 14-year-old boy, resulting in a calcaneus deformity of the foot, which has not been previously reported.

A 14-year-old boy presented with a history of deformity of the right foot, which was slowly progressive in nature.

The patient had a history of acute pyogenic osteomyelitis of the distal tibia at the age of 1 year, which was treated with antibiotics at a peripheral hospital.

After 3 months of the index episode, the patient developed swelling, followed by sinus discharge in the region of the distal tibia.

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The patient was diagnosed with a case of chronic osteomyelitis, and was subsequently treated with debridement, sequestrectomy and antibiotics at the age of 2 years.

The patient remained symptom-free for 1 year after the index operation.

Two years after the index operation, the patient’s parents noted a deformity of the right foot, for which he was treated conservatively at a peripheral hospital.

Upon further inspection of the deformity, there was a 5 cm long healed surgical scar on the medial surface at the junction of the upper and middle third of the tibia.

The tibia was curved with posterior convexity in its distal third which was associated with loss of prominence of the tendo Achillis.

The calcaneum was dorsiflexed, producing a calcaneal deformity with an associated forefoot cavus.

Anteroposterior and lateral radiographs of the right ankle revealed the obliteration of the epiphyseal line in the anterior half of the distal physis.

The calcaneotibial angle measured 50 degrees which signified a calcaneus deformity.

The authors propose that in the differential diagnosis of calcaneal deformities, asymmetric growth of the distal tibial epiphysis secondary to osteomyelitis of the distal tibia should also be kept in mind.

Copyright 2017 MASS4D® All rights reserved. 

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References:

1. Singh, D., Krishna, L. G., Kaur, J. (2014) Acquired Calcaneus Deformity Secondary to Osteomyelitis of the Distal Tibia. Journal of the American Podiatric Medical Association: January/February 2014, Vol. 104, No. 1, pp. 95-98.

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