• Sergio Charles-Lozoya, Gibran Ruíz-Zenteno, Héctor Cobos-Aguilar, María Lizcano-Martínez, Edgar Manilla-Muñoz, Miguel Leonardo De La Parra-Márquez, and Adrián García-Hernández.
• Health Science Division, Division of Plastic and Reconstructive Surgery, Unit of Hip and Pelvis Orthopedic Surgery, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social (IMSS), Monterrey, N.L., México.
• Medicine (Baltimore). 2022 Jun 24; 101 (25): e29283.

RationaleEvaluation of clinical and radiologic abnormalities in patients with postaxial hypoplasia of the lower extremity (PHLE) for treatment decisions represents a major challenge, which is more complicated when PHLE is associated with congenital dislocation of the patella.Patient Concerns: Herein, we present the case of an 8-year-old female patient with evident length inequality in her left lower extremity and inability to walk.DiagnosesRadiological evaluation revealed PHLE with fibular hemimelia, proximal femoral focal deficiency, tarsal coalition, and congenital patellar dislocation of the patella. The right lower extremity was also affected by fibular hemimelia.Interventions And OutcomesSurgical management included the Roux-Goldthwait technique for patellofemoral joint realignment, a medial knee stapled with Blount technique, and femur enlargement using the Wagner technique. The results from surgical intervention included a left femoral elongation of 6.7 cm featuring callus with angulation, displacement, and a discrepancy of 5 cm between femurs with a flexor contraction in the knee of -15° and a centralized knee.LessonPHLE accompanied by congenital dislocation of the patella has not been extensively described in the literature; therefore, there is no established management. Starting reconstruction at an early age, together with an adequate classification of the deformity, are essential factors when opting for limb reconstruction.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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