Isolated congenital anterolateral bowing of the fibula : A case report with 24 years follow-up

Only very few cases of congenital anterolateral bowing of the fibula have been described in literature. We report a girl with congenital anterolateral bowing of the fibula with a 24 year follow-up. Asymptomatic bowing of her left leg below the knee was noted at the age of three years. Radiographs showed an isolated anterolateral bowing of the fibula with a normal ipsilateral tibia. Supervised neglect was advised. A spontaneous fracture occurred one year later. A shortening osteotomy resulted in solid consolidation of the fracture. At the age of 27 years the deformity had progressed into a two-level fracture of the fibular diaphysis with pseudoarthrosis. The segment in-between the fractures was resected. Following this, the patient returned to a normal level of activities in just a matter of weeks. She could even participate in recreational tennis six weeks after surgery and was then discharged from the outpatient clinic. Isolated congenital anterolateral bowing of the fibula is a very rare condition and there is no consensus on its treatment. In this case, removal of the painful pseudarthrotic fragment of the fibula led to a good result.