{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T09:56:47Z","timestamp":1774691807515,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Congenital genu recurvatum (CGR) is a rare congenital knee deformity that can be diagnosed pre- or postnatally. Most CGR cases are treated during infancy by manipulation and serial casting or splinting. Only a few neglected cases of CGR in adults with the necessity of surgical treatment have been reported. This study presents the first case of neglected bilateral severe CGR combined with bilateral talipes equinocavovarus (BTE) in a 25-year-old woman. This case is unique, because BTE is secondary to CGR with persistent progression into adulthood. The patient underwent two-stage surgeries with 1.5-month intervals to correct the knee and foot\/ankle deformities. For CGR, a novel technique that combines posterior closing and anterior open wedge osteotomy was carried out to separately address the issues of 80\u00b0 and 60\u00b0 deformity, achieving a total correction of 140\u00b0 for both knee hyperextension deformities. For BTE, the modified Lambrinudi triple arthrodesis and almost complete plantar fascia release were performed for the treatment of foot\/ankle deformities. The patient had no neurovascular problems, and the wounds healed well. After 1 year of hospital-based rehabilitation training, the patient could stand and walk without the help of any walking-assist devices. The outcomes of the three- and nine-year follow-ups were highly satisfactory. Our patient represents a technically challenging case for orthopaedic surgeons because of the complexity of the surgical plan and techniques for the treatment of a patient concurrently having CGR and BTE.<\/jats:p>","DOI":"10.3390\/medicina61030543","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T09:17:39Z","timestamp":1742462259000},"page":"543","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Novel Surgical Technique for the First Case of Neglected Bilateral Severe Congenital Genu Recurvatum Combined with Bilateral Talipes Equinocavovarus"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-3229","authenticated-orcid":false,"given":"Kuan-Lin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 970374, Taiwan"},{"name":"Sports Medicine Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8585-597X","authenticated-orcid":false,"given":"Ting-Yu","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"},{"name":"Sports Medicine Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin-Le","family":"Eng","sequence":"additional","affiliation":[{"name":"Medical Department, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ing-Ho","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 970374, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"ref_1","unstructured":"Orphanet (2024, December 02). Search for a Rare Disease: Congenital Genu Recurvatum. Paris: Rare Disease Platform. Available online: https:\/\/www.orpha.net\/consor\/cgi-bin\/OC_Exp.php?lng=EN&Expert=295229."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.otsr.2016.04.008","article-title":"Congenital dislocation of the knee at birth\u2014Part I: Clinical signs and classification","volume":"102","author":"Mehrafshan","year":"2016","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.ijgo.2009.01.015","article-title":"Prenatal features of genu recurvatum and genu flexum","volume":"105","author":"Barber","year":"2009","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/uog.884","article-title":"Prenatal diagnosis of congenital genu recurvatum following amniocentesis complicated by leakage","volume":"22","author":"Gorincour","year":"2003","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11832-011-0333-7","article-title":"Congenital dislocation of the knee: A protocol for management based on degree of knee flexion","volume":"5","author":"Abdelaziz","year":"2011","journal-title":"J. Child. Orthop."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jpeds.2020.10.003","article-title":"Bilateral congenital dislocation of the knee","volume":"229","author":"Hirade","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"70","DOI":"10.5144\/0256-4947.1994.70","article-title":"Congenital genu recurvatum: A report of two cases with unusual presentations","volume":"14","author":"Joshi","year":"1994","journal-title":"Ann. Saudi Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3126\/jonmc.v1i1.7291","article-title":"Congenital genu recurvatum with dislocation of knee: A case report","volume":"1","author":"Kalawar","year":"2011","journal-title":"J. Nobel Med. Coll."},{"key":"ref_9","first-page":"23","article-title":"Congenital genu recurvatum: A case report from Tanzania","volume":"1","author":"Mlay","year":"2019","journal-title":"EAS J. Orthop. Physiother."},{"key":"ref_10","first-page":"172","article-title":"Congenital knee dislocation. Therapeutic protocol and long-term functional results","volume":"65","author":"Gorozarri","year":"2021","journal-title":"Rev. Esp. Cir. Ortop. Traumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.otsr.2016.04.009","article-title":"Congenital dislocation of the knee at birth\u2013Part 2: Impact of a new classification on treatment strategies, results and prognostic factors","volume":"102","author":"Rampal","year":"2016","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"21","DOI":"10.13107\/jocr.2250-0685.096","article-title":"Unilateral congenital knee and hip dislocation with bilateral clubfoot-a rare packaging disorder","volume":"3","author":"Tiwari","year":"2013","journal-title":"J. Orthop. Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"622","DOI":"10.2106\/00004623-197961040-00029","article-title":"Severe congenital genu recurvatum. Case report","volume":"61","author":"Ahmadi","year":"1979","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3928\/01477447-20100329-22","article-title":"Congenital dislocation of the knee in a 16-year-old girl","volume":"33","author":"Kazemi","year":"2010","journal-title":"Orthopedics."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"443","DOI":"10.2106\/JBJS.I.00128","article-title":"Surgical realignment of knees with neglected congenital dislocations in a forty-three-year-old man: A case report","volume":"92","author":"Assaghir","year":"2010","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"58","DOI":"10.2174\/1874325002014010058","article-title":"Congenital knee dislocation: Which classification to follow?","volume":"14","author":"Tiwari","year":"2020","journal-title":"Open J. Orthop."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"546","DOI":"10.2106\/00004623-199604000-00008","article-title":"Treatment of equinocavovarus deformity in adults with the use of a hinged distraction apparatus","volume":"78","author":"Oganesyan","year":"1996","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/j.jor.2018.09.001","article-title":"Approach to bone procedure in fixed equinovarus deformity in cerebral palsy","volume":"15","author":"Thamkunanon","year":"2018","journal-title":"J. Orthop."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/107110078400500105","article-title":"Surgical correction of spastic equinovarus deformity in the adult head trauma patient","volume":"5","author":"Keenan","year":"1984","journal-title":"Foot Ankle"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/543\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:57:02Z","timestamp":1760029022000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["medicina61030543"],"URL":"https:\/\/doi.org\/10.3390\/medicina61030543","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]}}}