Infantile Myofibromatosis

A 4 year old child presented to us with 11 cm tibial shortening, 90° anteromedial angulation at the junction of the middle and distal thirds with violent discoloration of the skin over the apex of deformity, and 180° internal rotation of the foot (the heel faces strictly forward and the forefoot directed posteriorly). There was valgus heel and metatarsus adductus. The diagnosis was infantile myofibromatosis. Operative treatment is with application of Ilizarov external fixator and double corticotomy to correct the deformities. The magnitude of lengthening achieved was 11 cm. The angulation was corrected and derotation of the foot was undertaken till the normal foot position was achieved. Besides, the foot deformity was corrected using the bloodless technique. Complications were (1) neurapraxia as the patient could not move his toes postoperatively, (2) pin track infection, and (3) partial recurrence of the deformity. Conclusion: Up to the best of our knowledge, this is the first time to report the management of deformities in cases with infantile myofibromatosis.