A Curious Distal Tibiofibular Neuropathic Fracture: A Case Report

Roberto A. Brandao, Dane K. Wukich

Research output: Contribution to journalArticlepeer-review


Hindfoot and distal leg neuropathic fracture collapse secondary to normal pressure hydrocephalus is a very rare clinical pathology. The authors present a case of a 69-year-old woman who sustained a distal tibiofibular fracture that resulted in a recurvatum deformity with idiopathic neuropathy and gait instability on initial presentation. A subtalar and ankle joint arthrodesis was performed achieving rectus alignment of the lower extremity with no postoperative complications. Her neuropathic etiology was negative for common causative factors, including diabetes, infection, nutritional deficiencies, congenital neuropathy, and trauma. Approximately 6 months postoperatively, the patient had persistent bilateral lower extremity weakness with the sensation of her “feet sticking to the floor” on ambulation. A referral to neurology revealed a normal pressure hydrocephalus as a possible etiology for her gait abnormalities and neuropathy. She required a ventriculoperitoneal shunt, with resolved gait disturbance and associated weakness approximately 1.5 years postoperatively. Levels of Evidence: Therapeutic, Level IV: Case report

Original languageEnglish (US)
Pages (from-to)563-566
Number of pages4
JournalFoot and Ankle Specialist
Issue number6
StatePublished - Dec 1 2016


  • Charcot arthropathy
  • gait abnormalities
  • normal pressure hydrocephalus
  • tibial recurvatum

ASJC Scopus subject areas

  • Surgery
  • Podiatry
  • Orthopedics and Sports Medicine


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