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Case Reports
. 2024 Jun 6;16(6):e61850.
doi: 10.7759/cureus.61850. eCollection 2024 Jun.

Hallux Flexion Deformity Secondary to Fibula Harvesting in a 10-Year-Old Patient With Neurofibromatosis

Freideriki Poutoglidou  1 , Andrea Sott  1 , Sohail Yousaf  1 , Kunalan Maruthainar  1 , Paul Hamilton  1
Affiliations
Case Reports

Hallux Flexion Deformity Secondary to Fibula Harvesting in a 10-Year-Old Patient With Neurofibromatosis

Freideriki Poutoglidou et al. Cureus. .

Abstract

Hallux interphalangeal joint (IPJ) flexion contracture is an uncommon deformity with various underlying causes, including trauma, neurological disorders, and connective tissue pathologies. We present a unique case of a 10-year-old female patient with neurofibromatosis type 1 (NF1) and a history of fibula transposition surgery, resulting in a hallux IPJ flexion contracture. We believe that the loss of the proximal fibular attachment of the extensor hallucis longus (EHL) following fibula harvesting resulted in EHL weakness and unopposed flexor hallucis longus (FHL) pull that eventually led to the contracture. The patient underwent various diagnostic assessments, ruling out other potential causes of the deformity. This case emphasizes the importance of considering previous surgical interventions when encountering flexion contractures of the toes.

Keywords: fibula harvesting; flexion deformity; hallux; interphalangeal joint; joint contracture.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. (A) AP and (B) lateral X-rays of the patient’s left forearm showing the transposed fibula to the left ulna
AP, anteroposterior
Figure 2
Figure 2. AP weight-bearing X-rays of both feet. The IPJ of the right hallux appears flexed and valgus angulated, but the X-rays are otherwise unremarkable
AP, anteroposterior
Figure 3
Figure 3. (A, B) Sagittal T2- and T1-weighted MRI scan images demonstrating a flexion of the IPJ of the right hallux with no other abnormal findings. (C, D) Axial T2- and T1-weighted MRI scan images demonstrating a flexion and valgus deviation of the IPJ of the right hallux with no other abnormal findings
See this image and copyright information in PMC

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