Sacral agenesis is a rare condition. This syndrome was first described by Hohl in 1852 and is usually associated with other anomalies such as vertebral deformities, deformed hypoplastic legs, urologic and gastrointestinal problems. We have experienced two cases of this deformity; one with partial sacral agenesis, and the other with partial lumbar agenesis and complete absence of sacrum.
Congenital Abnormalities ; Leg ; Sacrum

A bilateral gastrocnemius tertius muscle and a unilateral accessory soleus muscle were encountered during the routine educational dissection studies. The right gastrocnemius tertius muscle consisted of one belly, but the left one of two bellies. On the left side, the superficial belly of the gastrocnemius tertius muscle had its origin from an area just above the tendon of the plantaris muscle, the deep belly from the tendon of the plantaris muscle. The accessory soleus muscle originated from the posteromedial aspect of the tibia and soleal line of the tibia and inserted to the medial surface of the calcaneus. On the right side, the gastrocnemius tertius muscle had its origin from the lateral condyle of the femur, and inserted to the medial head of the gastrocnemius muscle. The co-existence of both gastrocnemius tertius and accessory soleus muscle has not, to our knowledge, been previously reported.
*Abnormalities, Multiple ; Adult ; Humans ; Leg/*abnormalities ; Male ; Muscle, Skeletal/*abnormalities

Ball-and-socket deformity of the ankle joint is a rare entity that is usually associated with inequality of leg length, fibular hyperplasia, coalition of the ankle, and ray deficiency. Etiology is unknown, congenital itself or secondary to congenital conditions in the ankle. Nonunion of medial malleolar is rare in bilateral ball and socket ankle joint without lower leg deformity. We report upon this case, and include brief reviwe of the literature.
Ankle Joint* ; Ankle* ; Congenital Abnormalities ; Hyperplasia ; Leg ; Socioeconomic Factors

PURPOSE: We investigate a new measurement method for bowleg deformity in children to reduce intra-observer and inter-observer error and to assess change in the angles measured with respect to the rotation of the lower leg. MATERIALS AND METHOD: Fifty-one children younger than 3 years old with bow leg were analyzed. To assess the intra-observer and inter-observer error of the Metaphyseal-Diaphyseal Angle, Intermetaphyseal-metaphyseal angle and Tibio-Femoral angle measurements, supine view antero-posterior radiographs of the lower legs were taken at the neutral rotation, at 10 degrees and at 20 degrees internal rotation positions. Also, the effect of the rotation of lower legs upon the measured angle was assessed by comparing and analyzing the angle values with respect to rotations of the lower leg. RESULTS: TInter-observer error showed statistically significant difference (p<0.05). All measured angles showed statistically significant differences with respect to the rotation of the lower legs. The measurement variability introduced by rotation was significantly greater than the intra-observer and inter-observer errors. The Intermetaphyseal-metaphyseal angle measurement had the lowest standard error and the highest correlation coefficient. CONCLUSION: The Intermetaphyseal-metaphyseal angle measurement seems a highly reliable method, which could be clinically utilized. Also, since the rotation of the lower legs influences the metaphyseal-diaphyseal angle, the clinician should consider this effect when studying a simple radiograph for bowleg deformity.
Child* ; Child, Preschool ; Congenital Abnormalities* ; Genu Varum ; Humans ; Leg

PURPOSE: To demonstrate the effectiveness of the conservative treatment which was introduced to the extraarticular triplane fractures of the distal tibia. MATERIALS AND METHODS: We reviewed radiographs and medical records of eight patients with extraarticular triplane fractures of the tibia. Four patients were treated with closed reduction and internal fixation and the others with closed reduction and plaster. RESULTS: In all patients, the union of fractures was obtained. Although the physes were closed early, there was no angular deformity or leg length discrepancy. CONCLUSION: In case of extraarticular triplane fracture, except for open fracture or failure of closed reduction, conservative treatment yield good result.
Child* ; Congenital Abnormalities ; Fractures, Open ; Humans ; Leg ; Medical Records ; Tibia*

From January 1987 to December 1989, Six patients with lipomyelomeningocele were operated. There were 4 females and 2 males. The chief complaints that caused these patients to seek help were cosmetic effect of the mass on back, urinary incontinence, ankle deformity and weak leg. The postoperative results were as follows : Patient treated before developing neurological deficit remained unchanged neurologically. Patient treated after developing neurological deficitwere left with neurological sequelae. lipomyelomeningoceles are serious lesion which recommand early prohylactic surgery.
Ankle ; Congenital Abnormalities ; Female ; Humans ; Leg ; Male ; Urinary Incontinence

PURPOSE: Single or multiple fibrous dysplasia of the proximal femur can cause coxa vara, Shepherd's crook deformity and a leg length discrepancy for those patients who require surgical treatment. We wanted to evaluate the efficiency of surgical treating fibrous dysplasia of the proximal femur. MATERIALS AND METHODS: Among the patients who underwent surgical treatment at our hospital during the period of June, 2001 to October, 2007, we selected 18 patients who underwent curettage and bone graft or valgus osteotomy and internal fixation due to proximal femur involvement. The clinical results were analyzed based on the patients' clinical records and radiologic findings. RESULTS: The group of patients with a normal neck-shaft angle (Group 1) could achieve satisfactory results by undergoing curettage, bone graft and internal fixation. The other group of patients who progressed to Shepherd's crook deformity (Group 2) could have satisfactory results when they underwent valgus osteotomy and soft tissue release or both proximal femur shortening osteotomy and valgus osteotomy, but not with undergoing valgus osteotomy only. CONCLUSION: Varus deformity in patients with fibrous dysplasia may progress even though they undergo valgus osteotomy. It is important to consider the preoperative biomechanical condition of the proximal femur before performing surgery.
Congenital Abnormalities ; Coxa Vara ; Curettage ; Femur ; Humans ; Leg ; Osteotomy ; Transplants

The Caudal regression syndrome is characterized by sacrococcygeal or lumbosacrococcygeal agenesis, of variable extent, most often accompanied by multiple musculoskeletal abnormalities of the pelvis and legs. It is rare fetal complication of diabetic pregnancy. Although the exact teratogenic mechanism is not known, hyperglycemia appears to play a crucial role as a teratogen. Strict control of diabetes preconceptually and in early pregnancy is presumed to reduce the risk of occurrence. We report a case of caudal regression syndrome detected by pelvic radiography and MRI in the newborn of the diabetic mother.
Humans ; Hyperglycemia ; Infant, Newborn* ; Leg ; Magnetic Resonance Imaging ; Mothers* ; Musculoskeletal Abnormalities ; Pelvis ; Pregnancy ; Radiography

PURPOSE: We investigated a statistical difference of tibial-articular surface (TAS) angles between radiographs of standing ankle anteroposterior (AP) and whole lower extremity view, and evaluated whether the tibial axis obtained from the standing ankle AP view reflects the original mechanical axis of lower extremity. MATERIALS AND METHODS: Both the standing ankle AP and whole lower extremity view were taken from 60 legs of 30 healthy volunteers without a history of ankle surgery or deformity of lower limb. To determine the tibial axis, Takakura's and Hintermann's method were employed in the standing ankle AP view. To compare these results with the original TAS angle, ANOVA and multiple comparison test were used. RESULTS: The mean TAS angle was 88.3 degrees(from hip joint to ankle), 89.5 degrees (from knee joint to ankle), 88.5 degrees (Takakura's method), and 90.2 degrees(Hintermann's method). Although there was a statistical significance (p=0.000) between these results, Takakura's method had no significant difference, compared to the results of whole extremity view by the multiple comparison test. CONCLUSION: The tibial axis obtained by Takakura's method reflects the original mechanical axis of lower extremity. When a surgical procedure is planned, however, it is necessary to consider that the ankle radiographs do not provide any information on the proximal deformity without the whole lower extremity view.
Animals ; Ankle ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Extremities ; Hip Joint ; Knee Joint ; Leg ; Lower Extremity

PURPOSE: This study evaluated the shortening and rotational deformity after closed intramedullary nailing of femur shaft fracture according to Winquist-Hansen classification type. MATERIALS AND METHODS: This study was based on 98 cases who received cloased intramedullary fixation about their femur shaft fractures between January 2000 and October 2005 with minimum 12 months follow up. The rotational deformity was analysed by Yang's method (45 cases) preoperatively and postoperatively, and the shortening by orthoradiogram (55 cases). Furthermore we analysed other complications, for example nonunion, infection, and metal failure. RESULTS: We found more than 15 degrees anteversion difference of both femurs in 10 cases. Among them, 9 cases were classified to type 3, 4. According to Winquist-Hansen classification, rotational deformity ranged from 3.7° (Type 1) to 8.9° (Type 4). More than 2 cm leg length discrepancy (LLD) was found in 9 cases, all of them were classified as Winquist-Hansen classification type 3, 4. In the type 1, LLD was checked as 3.2 mm and type 4, 14.2 mm. CONCLUSION: To prevent the shortening and rotational deformity after intramedullary fixation of Winquist-Hansen classification type 3, 4 femur shaft fracture, intraoperatively the exact contralateral femoral anteversion and length should be checked.
Classification* ; Congenital Abnormalities* ; Femur* ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Leg ; Methods