Clubfoot and Osteogenesis imperfecta — A rare combination - Case report and review of the literature

Abstract

Background: The combination of Osteogenesis imperfecta (OI) and congenital talipes equinovarus (CTEV), or clubfoot is a very rare one. The associated bone fragility with OI makes it difficult for manipulation and casting. Case report: We report the case of a child with OI type III with clubfoot. Using the Ponseti method, we started weekly serial manipulation and casting. After the 7th cast, we performed Percutaneous tendoachillis tenotomy (PCTA) under general anesthesia, to avoid undue resistance from a child while doing manipulation of foot. During the maintenance phase, child was given a foot abduction brace (23 hours/day). At six months follow up, full correction is maintained. Medical treatment with Zoledronic acid helped in decreasing fracture frequency and safe Ponseti method application. Conclusion: With the Ponseti method, it was possible to correct the deformity successfully, without causing pathological fractures.

Keywords

• Osteogenesis imperfecta
• Clubfoot
• Ponseti method
• Bisphosphonates