Limb Deformities

Limb deformities can be congenital- present at birth or may occur at a later stage as a result of fracture, infection, arthritis or tumor. Congenital deformities of the lower limbs are the developmental disorders that cause alteration in the shape and appearance of the legs. The exact cause for this is not known. There are several factors such as genetic factors which influence the fetal growth in the womb and teratogenic drugs and chemicals that can cause congenital deformities.

Some of the congenital deformities of the lower limb include:

  • Congenital talipus equino varus: Congenital talipus equino varus, commonly called as clubfoot is the most common and obvious of all the foot deformities. The feet may become twisted inwards in such a way that top of the foot comes in place where the bottom should be
  • Flat foot: Flat feet, also known as Pes planus is a deformity of the feet, in which the arch running lengthwise along the sole of the feet has collapsed or has not formed at all. It may happen in one or both feet. Infants’ feet may appear flat which is normal because the arch is yet to form
  • Congenital vertical talus: Congenital vertical talus (CVT) also known as Rocker-Bottom foot, is a rare condition and is often mistaken for calcaneovalgus, but it is a rigid deformity and not as flexible as calcaneovalgus foot. It occurs most frequently with other congenital anomalies such as spina bifida and arthrogryposis (multiple joint contractures present at birth) and is more common in males
  • Calcaneovalgus foot: This postural deformity is located at the ankle joint and the foot appears to be bent upwards. It occurs in newborns as a result of abnormal intrauterine position. It affects girls more commonly than boys
  • Congenital genu varus: Congenital genu varus (bowed legs) is a condition seen in children below 2 years. In this condition, the lower leg curves outwards so that when a child stands with both the feet joined a gap can be seen between the lower legs and knees. It is a normal variation in the appearance of the legs and gradually improves by the age of 3 to 4 years. Night splints may be given or osteotomy can be performed in severe cases
  • Tarsal coalition: Tarsal coalition is a developmental deformity that occurs because of fusion between two bones (tarsal bones) at back of the foot. Most of the children with tarsal coalition are born with this condition, but symptoms appear at ages 9-16 once the bone matures
  • Metatarsus adductus: Metatarsus adductus is a common forefoot deformity equally seen in boys and girls. The bones in the front part of the foot are bent or turned towards the body
  • Leg length discrepancy: Leg length discrepancy is a condition in which one leg is shorter than the other leading to problems in posture and walking pattern. There may be associated pain in the back, hip knee or ankle. It can be corrected by a reconstructive procedure called limb lengthening

Congenital hand deformities are deformities of the hand or any part of hand that are present at birth. These deformities can be particularly disabling as the hands are important for the child for its interaction. It should be treated at an early stage before the problem becomes severe.

Some of the common pediatric hand deformities include:

  • Radial and ulnar club hand deformity: This type of deformity involves all the tissues resulting in a short thumb, or complete absence of the thumb, and underdeveloped muscles and ulnar bone
  • Syndactyly: It is the most common deformity in which two or more fingers are fused together. Simple syndactyly involves fusion of only the soft tissues of fingers whereas complex syndactyly involves fusion of both soft tissues and bones of the fingers
  • Contractures: Contractures may result by improper differentiation of cells which may cause abnormal pulling of the digits as in congenital trigger thumb where the child may not be able to extend the thumb straight
  • Duplication: It is the abnormality where a child will have extra digits in the hand. The condition is called polydactyly and in many cases the extra digit would be the little finger
  • Overgrowth or macrodactyly: It is the excessive growth of a digit causing abnormally large digit. Macrodactyly is a rare condition and most commonly affects the index finger
  • Undergrowth or brachydactyly: It is the condition of underdevelopment of fingers or thumbs and may present with small digit which may be because of missing muscles, underdeveloped or missing bones, and complete absence of a digit
  • Constriction ring syndrome: The abnormality occurs because of a constricting band of tissue around a finger or arm that interrupts the blood flow to the digit and the normal growth of the tissues. It is often associated with other congenital abnormalities such as clubfoot, cleft lip, cleft palate, or other craniofacial anomalies