A case report of Gollop-Wolfgang complex in 12 years old boy

Abstract

Introduction: The Gollop-Wolfgang Complex (GWC) was initially described by Gollop et al. and is a rare congenital limb anomaly disorder characterized by the association of distal bifid femur and tibial agenesis.

Case presentation: This study presents a case of a 12-year-old boy with Gollop-Wolfgang Complex (GWC), a rare congenital limb anomaly disorder characterized by the association of distal bifid femur and tibial agenesis. The patient did not have any VACTERL abnormalities and had a normal level of intelligence. Examination revealed coxa valga in both hips and upper limbs on both sides, a shortened left leg with a palpable bony protuberance and absence of the patella, and a shortened right leg with a palpable fibula lateral to the knee and absent tibia with severe knee varus deformity on both sides. Both feet revealed equinovarus deformity with ectrodactyly. The patient underwent through-knee amputation and was fitted with two prostheses to provide enhanced functional support.

Clinical discussion: The etiology of GWC is still unknown, but errors in the complex genetic control of limb development are believed to be related.

Conclusion: Treatment choice depends on the deformity type, with through-knee amputation recommended for cases with observed flexion contracture, bifid femur, and tibial hemimelia, followed by modern prosthesis fitting for optimal outcomes. This case illustrates the efficacy of this surgical management and highlights the need for ongoing follow-up care.

Keywords: Case report; Distal bifid femur; Gollop-Wolfgang complex; Tibial agenesis.

Fig. 1

Normal hip (A) and normal left and right upper limbs (B and C).

Fig. 2

Left bifid femur (A) with the absence of left patella, severe knee varus deformity, and ipsilateral complete tibial hemimelia (A, B, C and Video 1). Left bifid femur (A) with the absence of left patella, severe knee varus deformity, and ipsilateral complete tibial hemimelia (A, B, C and Video 1).

Fig. 3

X-ray image of the left bifid femur and complete tibial hemimelia (A) and complete tibial hemimelia of the right limb (B).

Fig. 4

Absence of hallux and 2nd toe on the left foot and of the hallux on the right foot.

Fig. 5

Left and right limbs after the surgical reconstruction (A, B, and C).

Fig. 6

Patient walking independently 2 years following surgical reconstruction wearing right and left lower extremity prosthesis.