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Avulsion Fracture of the Plantar Calcaneocuboid Ligament in a Skeletally Immature Patient: A Case Report

Case Report | Volume 11 | Issue 2 | May-August 2025 | Page: 27-30 | Maulin Shah, Shalin Shah, Chinmay Sangole, Meet Jain, Vaibhav Mittal, Kunal Singla DOI- https://doi.org/10.13107/ijpo.2025.v11.i02.236 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2025; The Author(s). Submitted: 06/05/2025; Reviewed: 02/06/2025; Accepted: 14/07/2025; Published: 10/08/2025 Authors: Maulin Shah MS Ortho […]

Focal Fibrocartilaginous Dysplasia of the Distal Femur with Secondary Genu Valgum and Patellar Dislocation: Case Report and Literature Review

Case Report | Volume 11 | Issue 2 | May-August 2025 | Page: 21-26 | Rakesh Kumar, K. Venkatadass, S. Rajasekaran DOI- https://doi.org/10.13107/ijpo.2025.v11.i02.234 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2025; The Author(s). Submitted: 09/10/2024; Reviewed: 02/11/2024; Accepted: 11/06/2025; Published: 10/08/2025 Authors: Rakesh Kumar DNB Ortho [1], K. Venkatadass MS Ortho [1], […]

Avulsion Fracture of the Plantar Calcaneocuboid Ligament in a Skeletally Immature Patient: A Case Report

Focal Fibrocartilaginous Dysplasia of the Distal Femur with Secondary Genu Valgum and Patellar Dislocation: Case Report and Literature Review

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Avulsion Fracture of the Plantar Calcaneocuboid Ligament in a Skeletally Immature Patient: A Case Report

DOI- https://doi.org/10.13107/ijpo.2025.v11.i02.236

Open Access License: CC BY-NC 4.0

Submitted: 06/05/2025; Reviewed: 02/06/2025; Accepted: 14/07/2025; Published: 10/08/2025

Authors: Maulin Shah MS Ortho [1], Shalin Shah MS Ortho [1], Chinmay Sangole MS Ortho [1], Meet Jain MS Ortho [1], Vaibhav Mittal MS Ortho [1], Kunal Singla MS Ortho [1]

[1] Department of Pediatric Orthopedic Surgery, Orthokids Clinic, Ahmedabad, Gujarat, India.

Address of Correspondence
Dr. Maulin M. Shah
Consultant Pediatric Orthopedic Surgeon, Orthokids Clinic, Ahmedabad, Gujarat, India.
Email: maulinmshah@gmail.com

Abstract

Introduction: Isolated calcaneocuboid ligament (CCL) avulsion is a rare and often overlooked injury, previously described only in adults. Due to subtle or absent radiographic findings, diagnosis is frequently missed which is evident only on the lateral view radiographs of foot. We report, to our knowledge, the first paediatric case of plantar CCL avulsion, successfully treated with plaster immobilization.
Case: A 9-years-old male child presented to us with a dorsiflexion and inversion injury to the foot. While no fracture was evident on dorso-plantar and oblique foot radiographs, fracture was visible on the lateral radiograph as a bony avulsion fracture on the plantar aspect of the cuboid. MRI further delineated the morphology of the fracture pattern. Conservative management in the form of below knee cast was given. Good outcome was obtained at 1 year follow-up.
Conclusion: Avulsion fracture of the plantar calcaneocuboid ligament is rare and this is the first reported case of this injury in a child.
Keywords: Calcaneocuboid ligament, Lateral foot pain, Paediatric foot

References

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2. Nicastro JF, Haupt HA. Probable stress fracture of the cuboid in an infant. A case report. JBJS. 1984 Sep 1;66(7):1106-8.
3. Simonian PT, Vahey JW, Rosenbaum DM, Mosca VS, Staheli LT. Fracture of the cuboid in children. A source of leg symptoms. The Journal of bone and joint surgery. British volume. 1995 Jan;77(1):104-6.
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5. Melão L, Canella C, Weber M, Negrao P, Trudell D, Resnick D. Ligaments of the transverse tarsal joint complex: MRI–anatomic correlation in cadavers. American Journal of Roentgenology. 2009 Sep;193(3):662-71.
6. Leland RH, Marymont JV, Trevino SG, Varner KE, Noble PC (2001) Calcaneocuboid stability: a clinical and anatomic study. Foot Ankle Int 22:880–884
7. Wiley JJ. Tarso-metatarsal joint injuries in children. J Pediatr Orthop. 1981;1:255Y260.
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9. Englaro EE, Gelfand MJ, Paltiel HJ. Bone Scintigraphyin Preschool Children with Lower Extremity Pain of Unknown Origin.
10. Blumberg K, Patterson RJ. The toddler’s cuboid fracture. Radiology. 1991 Apr;179(1):93-4.
11. Bahel A, Joseph SY. Lateral plantar pain: diagnostic considerations. Emergency radiology. 2010 Jul 1;17(4):291-8.
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How to Cite this Article: Shah M, Shah S, Sangole C, Jain M, Mittal V, Singla K. Avulsion Fracture of the Plantar Calcaneocuboid Ligament in a Skeletally Immature Patient: A Case Report. International Journal of Paediatric Orthopaedics . May-August 2025; 11(2): 27-30.

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Focal Fibrocartilaginous Dysplasia of the Distal Femur with Secondary Genu Valgum and Patellar Dislocation: Case Report and Literature Review

DOI- https://doi.org/10.13107/ijpo.2025.v11.i02.234

Open Access License: CC BY-NC 4.0

Submitted: 09/10/2024; Reviewed: 02/11/2024; Accepted: 11/06/2025; Published: 10/08/2025

Authors: Rakesh Kumar DNB Ortho [1], K. Venkatadass MS Ortho [1], S. Rajasekaran MS Ortho [1]
[1] Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. K Venkatadass
Fellow in Paediatric Orthopaedics, Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
E-mail: Vk@gangahospital.net

Abstract

Background: Focal fibrocartilaginous dysplasia (FFCD) is a rare fibrous dysplasia that predominantly affects the long bones of children, often leading to angular deformities and limb length discrepancies. The condition is characterized by the presence of fibrous tissue and hyaline cartilage and can mimic other bone disorders.
Case Presentation: A 3-year-old girl presented with progressive left-sided genu valgum and patellar dislocation, noticed since the onset of ambulation at 18 months. Initial management involved observation, but due to worsening symptoms, further evaluation was sought. Clinical examination revealed a range of motion of the left knee from 0 to 100 degrees and lateral dislocation of the patella at 60 degrees of flexion. Radiological assessments showed a mechanical lateral distal femur angle (mLDFA) of 59 degrees and a well-defined fibrotic band on MRI, indicative of FFCD. A limb length discrepancy of 2 cm was present.
Intervention: Surgical management involved curettage of the fibrocartilaginous lesion and a corrective osteotomy using the LRS (Limb Reconstruction System) assisted technique, combined with the Roux-Goldwaith procedure to address the patellar dislocation.
Outcome: Postoperative follow-up over seven months showed satisfactory alignment of the femur, normal patellar tracking, and correction of the limb length discrepancy. Histological analysis confirmed the diagnosis of FFCD.
Conclusion: The combined approach of curettage and corrective osteotomy, along with soft tissue procedures, effectively managed the angular deformity and patellar dislocation in this case of FFCD. This case underscores the importance of early surgical intervention in managing progressive deformities associated with patellar dislocation due to FFCD.
Keywords: Focal fibrocartilaginous dysplasia, FFCD, Genu valgum, Femur deformity, Roux Goldwaith procedure, Curettage, Case report.

References

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2. Muezzinoglu B., & Oztop F. (2001). Fibrocartilaginous dysplasia: a variant of fibrous dysplasia. The Malaysian Journal of Pathology, 23(1), 35-39.
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4. Bian Z., Lyu X., Guo Y., Zhu Z., Feng C., Yang J., et al. (2020). Focal fibrocartilaginous dysplasia of the distal femur. Journal of Pediatric Orthopaedics B, 29(5), 466-471. https://doi.org/10.1097/BPB.0000000000000742
5. Jouve J.-L., Dohin B., & Bollini G. (2007). Focal Fibrocartilaginous Dysplasia (BFibrous Periosteal Inclusion^). J Pediatr Orthop, 27(1).
6. Thabet A. M., Belthur M. V., & Herzenberg J. E. (2010). Spontaneous resolution of angular deformity of the distal femur in focal fibrocartilaginous dysplasia: a case report. Journal of Pediatric Orthopaedics B, 19(2), 161-163. https://doi.org/10.1097/BPB.0b013e3283361b11
7. Johari A., & Anjum R. (2019). Spontaneous resolution of focal fibrocartilaginous dysplasia of femur on long-term follow-up: case report and review of literature. Journal of Pediatric Orthopaedics B, 28(2), 127-131. https://doi.org/10.1097/BPB.0000000000000570
8. Ruchelsman D. E., Madan S. S., & Feldman D. S. (2004). Genu Valgum Secondary to Focal Fibrocartilaginous Dysplasia of the Distal Femur. J Pediatr Orthop, 24(4).
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11. Beaty J. H., & Barrett I. R. (1989). Unilateral angular deformity of the distal end of the femur secondary to a focal fibrous tether. A report of four cases. The Journal of Bone and Joint Surgery. American Volume, 71(3), 440-445.
12. Zayer M. (1992). Tibia vara in focal fibrocartilaginous dysplasia. A report of 2 cases. Acta Orthopaedica Scandinavica, 63(3), 353-355. https://doi.org/10.3109/17453679209154802
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How to Cite this Article: Kumar R, Venkatadass K, Rajasekaran S. Focal Fibrocartilaginous Dysplasia of the Distal Femur with Secondary Genu Valgum and Patellar Dislocation: Case Report and Literature Review. International Journal of Paediatric Orthopaedics . May-August 2025; 11(2):21-26 .

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