🦵 Section 716.5 · Congenital Angular Deformities of the Tibia and Fibula

Nelson Textbook of Pediatrics 22nd Edition | Posteromedial tibial bowing: benign, associated with calcaneovalgus foot, leg-length discrepancy ~4 cm. Anteromedial bowing: fibular hemimelia, equinocavovarus foot, tarsal coalition. Anterolateral bowing: congenital pseudarthrosis of tibia (CPT), associated with neurofibromatosis type 1 (50-60%), very difficult to treat. Management: observation, limb lengthening, amputation, vascularized fibular graft.

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📋 30 Clinical Scenarios — Congenital Angular Deformities of Tibia/Fibula

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Congenital Tibial/Fibular Deformities

Select a presentation to review diagnostic clues and management per Nelson 716.5.

📋 Stepwise Management of Congenital Tibial/Fibular Deformities

🔑 Key Principles — Nelson Section 716.5
• Posteromedial tibial bowing: Benign. Associated with calcaneovalgus foot. Angulation corrects with growth. Mean LLD ~4 cm at maturity. Manage LLD with epiphysiodesis or lengthening.
• Anteromedial bowing (fibular hemimelia): Most common cause. Associated with femoral shortening, genu valgum, patellar instability, absent lateral rays, equinocavovarus foot, tarsal coalition. Treatment: foot reconstruction vs Syme/Boyd amputation.
• Anterolateral bowing: Congenital pseudarthrosis of tibia (CPT). Associated with neurofibromatosis type 1 (50-60%). Paley classification. Very difficult to union. Treatment: bracing, vascularized fibular graft, IM nailing, circular frame, or below-knee amputation.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Congenital Angular Deformities of Tibia & Fibula (Nelson 716.5)