title: Pediatric longitudinal epiphyseal bracket: Review and case presentation.
abstract: The longitudinal epiphyseal bracket is a rare deformity affecting the long and short bones of the hands and feet, creating an aberration in growth. The deformity is present in 2% to 14% of congenital hand and foot deformities, with 11% of all cases found in the great toe. Ultrasound may then be used to confirm the diagnosis. Radiographs usually show the presence of a bracket epiphysis once there is some ossification, but until then, the radiographs can appear normal. With the use of ultrasound, a suspected preossified bracket can be visualized and can establish the diagnosis. The purpose of this article is to present such a case with a preossified epiphyseal bracket of the great toe. The child presented initially with unremarkable x-rays, but the diagnosis was made with clinical suspicion and use of ultrasound. After surgical resection of the brackets, there was progressive improvement in the short-term follow-up. Long-term follow-up is essential until skeletal maturity, and, if the deformity persists, further surgical care may need to be implemented.
authors.affiliation: Foot and Ankle of West Georgia, 2751 Warm Springs Road, Suite A, Columbus, GA 31904, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Schreck
mesh_terms: D002675:Child, Preschool; D004838:Epiphyses / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D011859:Radiography; D014033:Toe Joint / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery